Cora and I often find that we sleep restlessly on the first night of a mountain backpacking trip. The lack of a familiar bed undoubtedly plays a role, but equally important is the sudden change in altitude. Many campsites in the Colorado Rockies are at 10,000 or 11,000 feet. Cora and I live in Boulder at an elevation of about 5,000 feet. We usually drive to the trail head and hike in on the first day. The abrupt change in altitude is sometimes sufficient to produce a mild version of the malady known as mountain sickness, which is characterized by fitful sleep, loss of appetite and a persistent headache, particularly at night while lying down. Flatlanders coming up from sea level often experience the same symptoms with greater intensity. For me and Cora, the second night is usually much better than the first, while the third is better still. Drinking plenty of fluids – enough to keep your urine clear – helps prevent mountain sickness. If you can, spend a night at an intermediate elevation, perhaps in a nearby mountain town, before beginning the hike. Most people can adjust well if they give themselves enough time. If you do start to develop uncomfortable symptoms, avoid overexertion, but don't confine yourself to bed. You'll often find that mild exercise actually makes you feel better. If the symptoms persist, descend. Losing several thousand feet of elevation is an almost certain cure. Backpackers in the Himalayas and Andes, who may be camping at much higher elevations than backpackers in the continental United States, should pick up a manual on mountain sickness and its dangerous cousins, pulmonary and cerebral edema. One good one is Dr. Peter Hackett's book Mountain Sickness: Prevention, Recognition and Treatment, published by The Mountaineers Books.

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