The relationship between anxiety and acute mountain sickness

Abstract

IntroductionWhilst the link between physical factors and risk of high altitude (HA)-related illness and acute mountain sickness (AMS) have been extensively explored, the influence of psychological factors has been less well examined. In this study we aimed to investigate the relationship between ‘anxiety and AMS risk during a progressive ascent to very HA.MethodsEighty health adults were assessed at baseline (848m) and over 9 consecutive altitudes during a progressive trek to 5140m. HA-related symptoms (Lake Louise [LLS] and AMS-C Scores) and state anxiety (State-Trait-Anxiety-Score [STAI Y-1]) were examined at each altitude with trait anxiety (STAI Y-2) at baseline.ResultsThe average age was 32.1 ± 8.3 years (67.5% men). STAI Y-1 scores fell from 848m to 3619m, before increasing to above baseline scores (848m) at ≥4072m (p = 0.01). STAI Y-1 scores correlated with LLS (r = 0.31; 0.24–0.3; P<0.0001) and AMS-C Scores (r = 0.29; 0.22–0.35; P<0.0001). There was significant main effect for sex (higher STAI Y-1 scores in women) and altitude with no sex-x-altitude interaction on STAI Y-1 Scores. Independent predictors of significant state anxiety included female sex, lower age, higher heart rate and increasing LLS and AMS-C scores (p<0.0001). A total of 38/80 subjects (47.5%) developed AMS which was mild in 20 (25%) and severe in 18 (22.5%). Baseline STAI Y-2 scores were an independent predictor of future severe AMS (B = 1.13; 1.009–1.28; p = 0.04; r2 = 0.23) and STAI Y-1 scores at HA independently predicted AMS and its severity.ConclusionTrait anxiety at low altitude was an independent predictor of future severe AMS development at HA. State anxiety at HA was independently associated with AMS and its severity.

Differences in Tolerance to Hypoxia: Physiological, Biochemical, and Molecular-Biological Characteristics

“…[ 15 , 217 ]. Such data are consistent with the information above about humans: indirect marker of susceptibility to AMS development may be increased anxiety at sea level [ 152 ]. On the contrary, in tolerant-to-hypoxia animals, excitability and anxiety are reduced, and moderate aggressiveness, more pronounced internal inhibition, low sensitivity to any provoking factors and a tendency to social domination are manifested, and they are more resistant to anesthesia.…”

“…An indirect marker of low tolerance to AMS development may be increased anxiety at sea level [ 152 ]. It was demonstrated that trait anxiety at low altitudes was detected as an independent predictor of future pronounced AMS development at a high altitude.…”

Investigation of the gene co-expression network and hub genes associated with acute mountain sickness

“…Generally, the physical symptoms such as fatigue or headache may develop ascending rapidly to altitudes > 2500 m [15,16]. Moreover, the physical symptoms and impaired alveolar oxygen diffusion tend to be more severe over 4500 m [17].…”

Prevention of Acute High-Altitude Illness by Health Care Management during Endurance Motor Rallies

“…Having an HCM relieved anxiety among the crew. This is notable because anxiety is associated with AMS according to the State-Trait-Anxiety-Inventory (STAI) 27) . Anxiety comprises current and sustained types, the latter of which is a predictor of severe AMS, and it is associated with AMS severity.…”