How high you'll be
For comparison, Shimla and Manali are at about 2,000–2,400 m, where most people feel fine. Things change above about 2,500–3,000 m, where the air holds noticeably less oxygen.
| Place | Approximate altitude |
|---|---|
| Keylong (Lahaul) | 3,080 m |
| Jispa (Lahaul) | 3,200 m |
| Leh | 3,500 m |
| Kaza (Spiti) | 3,650 m |
| Chandratal | 4,300 m |
| Kunzum La | 4,550 m |
Who gets it
Anyone can, regardless of age or fitness; being fit doesn't protect you. The main risk factor is how quickly you gain height, especially how high you sleep. Common symptoms are headache, nausea, tiredness, poor sleep and loss of appetite, usually starting six to twelve hours after arriving. Mild symptoms often ease after a day or two of rest at the same altitude.
Plan a slower climb
By road, you control the pace. For Spiti, enter through Kinnaur from Shimla, with nights at Sangla or Kalpa before Kaza, rather than driving straight over Kunzum La from Manali. For Leh, spend a night or two in Manali, then a night in Keylong or Jispa, and avoid sleeping at Sarchu on the first night. For Chandratal, visit on the way out of Spiti, when you're already used to the height.
Ladakh's tourism department advises at least 48 hours of rest on arrival in Leh, and notes that arriving by road doesn't remove the need to acclimatise.
- Sleep a little higher each night, not much higher
- Rest on the first day at a new altitude
- Leave the big passes for when you're acclimatised
Day-to-day habits that help
Drink plenty of water, avoid alcohol and smoking for the first days, eat light meals, and keep exertion gentle until you feel normal. Some travellers take medication on medical advice; that's a decision to make with your doctor before the trip, not something to start on the road.
Warning signs: when to descend
A severe headache that doesn't ease, vomiting, breathlessness while resting, a wet cough, confusion, clumsiness or unusual drowsiness are warning signs of serious altitude illness. Don't go higher, and descend as soon as possible, even a few hundred metres. Tell your driver straight away; our drivers know where the nearest lower ground and medical help are on each route. Kaza and Leh have hospitals.
What to pack for high-altitude trips
Bring layers for cold nights, sunscreen and sunglasses for the strong sun, a refillable water bottle, and a small first-aid kit with headache tablets and oral rehydration salts. Carry any regular medicines you take, with enough for delays, since pharmacies are few beyond Kaza and Leh.
Frequently asked questions
Will I get altitude sickness in Manali?+
Unlikely: Manali is at about 2,050 m. The risk starts on trips to Rohtang, Lahaul, Spiti and Ladakh.
Is it safer to reach Spiti from Shimla or Manali?+
From Shimla, through Kinnaur, because the climb is gradual over several days.
How long should we rest in Leh?+
Ladakh's tourism department advises at least 48 hours on arrival.
Can children travel to Spiti or Ladakh?+
Many do, with a slow itinerary and close attention to symptoms. Talk to your doctor first, especially for young children.
