Predictors and models of hypoxia and altitude tolerance in humans

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Humans travel to altitude with increasing frequency for work and for recreation, and are frequently subject to difficulties such as fatigue, headache and poor performance, primarily as a result of the low levels of oxygen at these locations. The mechanism of these responses is not well understood. Despite decades of research, it is hard to predict those individuals who will be highly acclimatize well to altitude, and those who are not. Many obvious potential predictors such as age, fitness, and even the level of oxygen in the blood have proven to be unreliable. A key reason for this is that factors other than altitude can stress the human body, and cause similar responses. These factors include exertion, dehydration, and even hangover or migraine. The purpose of the proposed research is to look for new ways to predict which individuals will perform well at altitude. We specifically aim to look at neurological predictors (such as balance and cognition), and genetic predictors (genes that indicate whether an individual will perform well at altitude). Our preliminary work has shown that a basic balance test seems to be able to discern who develops acute mountain sickness at altitude. We have also found two potential genes that might help us predict who performs poorly at altitude. We would like to build on this previous research with a series of studies in the laboratory and in the field. Furthermore, we have found anecdotally that those who perform more cognitively challenging tasks while at altitude may perform worse than those who do not. We would like to scientifically test whether cognitively challenging activity makes individuals perform worse at altitude.We will combine both laboratory research (performed in our altitude chamber) and field research, conducted at our research sites in the Himalayan Mountains of Nepal, to validate our existing predictors, and to search for and test new predictors of altitude response. We have developed a novel smartphone application that can be used to collect much of this data, and will be able to also measure important variables such as balance, coordination and atmospheric pressure.Finding these new predictors of altitude response will not only improve our ability to predict who will perform or suffer at altitude, it will also enhance our understanding of the mechanisms behind how humans respond to high altitude.