At the highest elevations, above about 3,000 meters in the northern and the central Andes, apunamiento or soroche can be an annoyance and even a danger, especially to older people or those with respiratory problems. Even among young, robust individuals, a quick rise from sea level to puna within a couple of hours can cause intense headaches, vertigo, either drowsiness or insomnia, shortness of breath, and other symptoms. Combined with hypothermia, it can be life-threatening.

For most people, rest and relaxation help relieve these symptoms as the body gradually adapts to the reduced oxygen; aspirin or a comparable painkiller will combat headache. Should symptoms persist or worsen, moving to a lower elevation will usually have the desired effect. Some individuals have died at elevations above 4,000 meters; it is better to stay at an intermediate altitude than to travel to very high elevations in a single same day. Do not overeat, avoid or limit alcohol consumption, and drink extra fluids.

The second edition of Stephen Bezruchka’s Altitude Illness, Prevention & Treatment (Seattle: The Mountaineers, 2005) deals with the topic in great detail; the fifth edition of James A. Wilkerson’s edited collection Medicine for Mountaineering & Other Wilderness Activities (Seattle: The Mountaineers, 2001) discusses other potential problems as well.