Altitude in Spiti: how to acclimatise well

Why altitude is the real risk in Spiti

Ask people who have travelled in Spiti what went wrong, and you rarely hear about crime or bad food. You hear about headaches, sleepless nights and the day someone had to be driven down. Kaza, the main town, sits at 3,650 m. The villages most people want to see, Kibber, Langza, Hikkim and Komic, are between about 4,200 and 4,590 m. Chandratal's camps are at about 4,250 m. Even Tabo, the lowest stop, is around 3,050 m.

At these heights there is less oxygen in every breath, and the body needs days to adjust. Most travellers get mild symptoms at first. A smaller number develop acute mountain sickness, and in rare cases it progresses to fluid on the lungs or brain, which is a medical emergency. The single biggest factor is how fast you gain sleeping altitude. We are not doctors, and this guide is not medical advice; talk to your doctor before you go, especially if you have heart, lung or blood pressure conditions, or are pregnant.

Shimla and Kinnaur, or Manali

There are two roads into Spiti, and for acclimatisation they are very different. From Manali, the road goes through the Atal Tunnel, along the Chandra valley and over Kunzum La to Kaza, about 180–200 km in one long day. You start at about 2,050 m, cross 4,590 m and sleep at 3,650 m. That is a jump of about 1,600 m in sleeping altitude in a day, well beyond what mountain medicine guidance usually suggests.

From Shimla, the Hindustan–Tibet road follows the Sutlej through Kinnaur. Most travellers sleep at Narkanda or Sarahan, then at Kalpa at about 2,960 m, then at Nako at 3,625 m, then at Tabo at 3,050 m, before reaching Kaza. The body gets four or five nights to adjust before 3,650 m. That is why we route almost every trip in through Kinnaur and out over Kunzum La when it is open, roughly mid-June to October. Check current status before you travel.

town · 3,650 mKazamonastery · 3,050 mTabo

A sensible day-by-day climb

Common guidance for travel above 3,000 m is to raise your sleeping altitude by no more than about 300–500 m a day, and to add a rest day every three or four days or every 1,000 m. Spiti's geography does not always allow that exactly, but you can get close by choosing the order of nights well. Day trips higher than where you sleep are fine and even helpful: climb high, sleep low.

This is the order we use for most first-time travellers.

• Night 1: Narkanda or Sarahan, below 2,800 m.
• Night 2: Kalpa, about 2,960 m.
• Night 3: Nako, 3,625 m. Short walks only.
• Nights 4–5: Tabo, 3,050 m. A rest and recovery stop.
• Nights 6–8: Kaza, 3,650 m. First day light; village loops from day two.
• Night 9 onwards: Kibber, Langza or Chandratal only if you have slept well in Kaza.

Warning signs and when to go down

Mild symptoms are common on the first night at a new height: headache, poor sleep, loss of appetite, a little nausea, breathlessness when climbing stairs. They usually ease within a day or two if you rest and do not go higher. Tell your companions, host or driver how you feel; people often hide symptoms so as not to spoil a trip.

Some signs mean you must go down without waiting for morning if it is safe to drive. From Langza, Kibber or Chandratal that usually means Kaza or lower; from Kaza, it means Tabo or the Kinnaur side. Kaza has a hospital, and larger hospitals are in Reckong Peo and Manali. Call for help early rather than late.

• A headache that does not ease with rest, water and a simple painkiller.
• Vomiting, or being unable to eat or drink.
• Breathlessness at rest, or a wet cough.
• Confusion, unusual drowsiness or stumbling when walking a straight line.
• Anyone who gets worse instead of better after a night at the same height.

Habits that help

None of these replace a slow climb, but together they make the first nights easier. Drink steadily through the day; the air is very dry, and dehydration feels like altitude sickness. Eat carbohydrate-rich meals such as rice, dal, thukpa and tingmo. Avoid alcohol and smoking for the first nights above 3,000 m, and avoid sleeping pills unless your doctor has approved them for altitude.

Walk slowly, especially on stairs and slopes, and do not run for photographs at Komic or Kunzum La. Keep warm, because cold makes everything harder. Some travellers take medication to help acclimatisation, but only a doctor who knows your health can advise on that. Protect yourself from the sun with a hat, sunglasses, sunscreen and lip balm; UV at 4,000 m is harsh even on cool days.

What to pack for altitude

A small kit makes high nights in Spiti easier and safer. None of it is expensive, and most of it is hard to buy once you are past Reckong Peo or Manali.

Pack layers rather than one heavy coat: a thermal base, a fleece and a down or synthetic jacket. Nights at Kaza fall close to freezing even in September, and at Chandratal and Langza they go below it. Add a warm cap, gloves and thick socks for sleeping. A one-litre steel bottle, oral rehydration sachets and simple painkillers your doctor is happy with help on long drive days. A pulse oximeter is useful but only as a rough guide; how you feel matters more than the number. Carry any medicines your doctor prescribes, sunscreen, lip balm with sun protection, and a headtorch for homestay nights when the power goes off.

Children, seniors and medical conditions

Children and older travellers can and do visit Spiti, but plan more carefully. Choose the Kinnaur approach, keep drive days under six hours where possible, sleep in Tabo, Kaza and Nako rather than in villages above 4,000 m, and make Chandratal optional. Young children may not say they feel unwell, so watch for irritability, poor feeding and unusual sleepiness.

Anyone with heart or lung disease, anaemia, high blood pressure, or who is pregnant should take medical advice before booking. For a gentler first taste of the high Himalaya, a short Lahaul trip that sleeps at Keylong and Jispa, around 3,100–3,200 m, is a good alternative to full Spiti.