Was it altitude sickness or overexertion?

September 6, 2015 10:27 PM

Many years ago I hiked Yosemite Falls roundtrip from the valley floor, and found myself very short of breath not on the trail, but much later, in the middle of the night while camping in the valley.

I was in my early teens at the time. My parent was fine both during and after the hike.

We chose the Falls hike for its relatively short distance, but it wound up being very steep, obviously. We started out late and didn't have enough food or water, so we had to hurry during the second half of the ascent and all the way down. However, we did make the roundtrip before dark descended, had dinner and rehydrated, and everything seemed fine until I went to bed.

I woke up sometime in the middle of the night feeling like I could barely breathe, accompanied by what I remember as stabbing chest pains. After several hours of enduring this, I was on the verge of making the parent take me to urgent care when the shortness of breath suddenly lifted or I managed to fall asleep. I've never experienced that feeling since.

Is it possible to have altitude sickness that sets in hours afterward, at lower elevation? Was I just overexerted? Dehydrated? Or a combination of these?

I've hiked the Falls in adulthood without experiencing any of the above again, thankfully.

posted by ziggly to Health & Fitness (9 answers total)

My hypothesis is that it had nothing to do with the hike or location and was just a single incidence of precordial catch.
posted by MsMolly at 10:40 PM on September 6, 2015 [1 favorite]

Response by poster: Interesting! I'd be inclined to agree, but if I remember correctly the pain woke me up, and the link says the syndrome never occurs during sleep.
posted by ziggly at 11:08 PM on September 6, 2015

My only adverse reaction to altitude also happened a few hours later at sea level. Always kind of wondered about it. We summited a high mountain in our car and a few hours later in our hotel I became suddenly, inexorably sleepy - like, in the middle of a sentence I could no longer even sit up I was so tired. I've never had anything like that happen to me before or since, and I've been at altitudes that made people around me ill a few times. Definitely not overexertion since all I did was sit in the car and walk around at the summit. So, count me as exactly one data point, haha.
posted by town of cats at 11:40 PM on September 6, 2015

It sounds like Cheyne-Stokes: altitude (and other problems) can cause disordered breathing during sleep, which usually causes disturbed sleep but can also result in people waking up feeling as if they're being suffocated, and with chest pains. The experience of it can be erratic - some people always get it, some people sometimes do. If you're tired and dehydrated that can also exacerbate the symptoms of altitude sickness.
posted by AFII at 1:29 AM on September 7, 2015

I've taken a lot of wilderness first aid classes and re-certification classes and here's my take on it: while it is true that altitude sickness can make you sleep badly and one sign of High Altitude Pulmonary Edema (HAPE), which is very serious because it's basically your lungs starting to fill with fluid, is shortness of breath while you are at rest, stabbing chest pain is not usually a related symptom. And if you did in fact have HAPE that had progressed far enough that you felt like you couldn't breathe properly, then it is very unlikely that it would have just gone away on its own, since the only cure for HAPE that we know of is descending to a lower altitude.

To me, it sounds like you had a nocturnal panic attack, which might have been caused by sleeping poorly because of the altitude, then got freaked out and started to hyperventilate, which made your panic attack worse, which made you hyperventilate more, which got you into a vicious circle for a couple of hours.
posted by colfax at 4:12 AM on September 7, 2015 [1 favorite]

(Cheyne Stokes isn't necessarily an indication of HAPE; some people interpret the feeling of suffocation as chest pain, especially if they've never experienced something like that before; it can also disorder sleep leading to vivid or lucid dreams which can be confusing/make it hard to judge time periods, etc).
posted by AFII at 6:25 AM on September 7, 2015

I'm thinking it wasn't altitude sickness, which occurs usually over 8000 feet. The maximum altititude of the Yosemite Falls Trail is 6500 feet (or 6900 if you added on Yosemite Point).
posted by cecic at 6:35 AM on September 7, 2015 [1 favorite]

Since we can only speculate, it may have been an asthma attack. Usually when I have an attack while sleeping, my chest hurts like hell from the effort involved in trying to breathe. I dunno about others, but my attack will sometimes go away on their own after a few hours. So, maybe you had an attack from exposure to some allergen or the exertion.
posted by Pogo_Fuzzybutt at 6:38 AM on September 7, 2015

I would say panic attack / anxiety attack based on my own history. (We thought it was exercise induced asthma until I got a flow meter that said I was actually breathing *more* not less.) Also based on timing (not while you were at height), sudden resolution, and lack of recurrence.
posted by Lady Li at 8:51 PM on September 7, 2015