Anxiety and Acute Mountain Sickness: Comparative Analysis of Active and Passive Ascents to 3600 Meters

Document Type : Original Research

Authors

1 Department of Exercise Physiology, Faculty of Sports Science, Razi University, Kermanshah, Iran

2 Department of Exercise Physiology, Faculty of sport sciences, Razi University, Kermanshah, Iran

Abstract

Introduction: High-altitude exposure is increasingly common due to work and leisure activities. While physical factors contributing to acute mountain sickness (AMS) are well-documented, the role of psychological factors, particularly anxiety, remains underexplored. This study aimed to evaluate anxiety levels and acute mountain sickness during active and passive ascents.
Methods: In a cross-sectional, counterbalanced study, 12 healthy male participants aged 20–29 years, underwent both active (hiking) and passive (cable car) ascents to 3600 meters. Each ascent was separated by a two-month washout period. Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI-Y1), and AMS symptoms were evaluated using the Lake Louise Score (LLS) at multiple time points post-ascent.
Results: No significant difference in anxiety levels was observed between active and passive ascents (p=0.291). However, during active ascent, significantly higher anxiety levels were exhibited by participants who developed AMS compared to those who did not develop AMS (p=0.046). A positive correlation between anxiety scores and LLS was found during both active (r=0.681; p=0.015) and passive (r=0.578; p=0.049) ascents. Pre-ascent anxiety levels did not significantly correlate with LLS at altitude after active or passive ascents (p=0.389 and p=0.339).
Conclusions: Anxiety levels post-ascent are associated with the occurrence of AMS, regardless of ascent method. Monitoring anxiety may aid in identifying individuals at risk for AMS, emphasizing the need for psychological assessments in high-altitude expeditions.

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History

  • Receive Date: 17 July 2025
  • Revise Date: 24 August 2025
  • Accept Date: 28 November 2025
  • Publish Date: 21 March 2026

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