Guide
reaching leh
There are two ways to reach Ladakh and its capital city Leh: by road via Manali (Himachal Pradesh) or Srinagar (Kashmir) and by air with a flight to Kushok Bakula Rimpochee airport located just 4 km from Leh city centre. The best option is to: go to Ladakh by air with a flight from Delhi to Leh and enjoy the most spectacular flight in India with stunning aerial views of the snow-capped peaks as you fly over the Himalayan mountains spend the first day acclimatizing and visiting Leh city spend a week or two exploring the Ladakh region (Indus valley, Nubra valley, Pangong lake…) leave Ladakh by road to Manali or to Srinagar for a memorable road trip
how to cope with altitude sickness
A study and survey on AMS among tourists in Leh conducted by NCBI shows that: 22 % of the tourists reaching Leh-Ladakh by air suffer from mild AMS, 31 % of the tourists reaching Leh-Ladakh by road from Srinagar suffer from mild AMS, 57 % of the tourists reaching Leh-Ladakh by road from Manali suffer from mild AMS and some of them develop more severe forms. Therefore, tourists are advised to travel to Leh-Ladakh by air to minimize the risk of altitude sickness. Tourists are strongly advised against travelling by road from Manali to Leh. This road trip should be done only when properly acclimatized to the altitude, at the end of the Leh-Ladakh trip, from Leh to Manali.
Planning and acclimatization
- Visit Leh city, the Indus valley and the Sham region at the beginning of your trip in Ladakh. These places lie at an altitude between 2,700 and 3,700 metres and you can travel around there during acclimatization time.
- Go to the Nubra valley after minimum 2 days of acclimatization. Even though Khardung La pass is at very high altitude (5,602 metres), you will only spend a short time at this elevation and you will be back to a lower altitude when you reach the Nubra valley (3,150 metres).
- Travel to Pangong lake (4,250 metres) after minimum 3 or 4 days of acclimatization. Note that suffering from AMS there can be critical because there is no easy way to drive to lower altitude, you would need to go through Chang La pass (5,360 metres) to get back to Leh.
- Visit Tso Moriri lake (4,530 metres) after minimum 4 days of acclimatization.
- Drive from Leh to Manali or from Leh to Srinagar at the end of your trip in Ladakh.
Preventing altitude sickness
To prevent Acute Mountain Sickness (AMS):
- take 2 or 3 days of acclimatization in Leh or in the Indus valley before going to higher altitude
- avoid increasing your sleeping altitude by more than 500 metres a day (you can go higher during the day, when crossing a pass for example, as long as you sleep at a lower altitude)
- avoid strenuous physical activities, walk slowly
- stay properly hydrated (acclimatization is often accompanied by fluid loss, so you need to drink plenty of water, at least 4 litres per day)
- avoid alcohol and smoking
- eat well, high-calorie and high-carbohydrate meals
- protect yourself from the cold and the sun (hat, sunglasses, sunscreen, clothes)
Mild AMS
Symptoms:
- mild headache
- shortness of breath
- loss of appetite or nausea
- dizziness
- disturbed sleep or insomnia
What to do:
- rest at the same (or lower) altitude until the symptoms disappear
- ibuprofen or paracetamol for headache
- drink enough water
- if not better after 12 hours, go down by at least 500m
Moderate AMS
Symptoms:
- moderate headache
- permanently out of breath
- nausea or vomiting
- decreased coordination (ataxia)
- increasing weakness and fatigue
What to do:
- go down by at least 500m
- use oxygen cylinder (if available)
- drink enough water
Severe AMS
Symptoms:
- strong headache
- severe shortness of breath
- vomiting
- loss of balance, inability to walk
- decreasing level of consciousness, irrational behaviour
- swelling of face or hands
What to do:
- go down by 700m immediately
- use oxygen cylinder (if available)
- call for rescue
- evacuation to a medical facility for treatment (hyperbaric chamber at Leh hospital)