Background Acute mountain sickness (AMS) is a common, transient condition characterized primarily by headaches, and it can also be associated with fatigue, dizziness, and nausea with vomiting. The symptoms of AMS are most pronounced after the first night spent at a new altitude. At sea level, changes in barometric pressure per given time have been associated with migraine headaches. We sought to investigate whether changes in barometric pressure, subjective sleep quality index, and other candidates contributed to the risk of developing AMS on Mount Fuji in Japan. Method We surveyed 353 trekkers who stayed overnight at a mountain lodge before summitting Mount Fuji. We collected information regarding sex, age, sleeping altitude at the hut, and perceived sleep quality index including sleep time. AMS was assessed with the Lake Louise Scoring system. Barometric pressure and ambient temperature were collected at the 5th station (2305 m) and at the summit (3776 m). Result The overall prevalence of AMS in our cohort was 41.4% (Lake Louise Score ≥ 3 with headache, n=146). Using logistic regression, three factors were combined to generate a robust model for determining the risk of AMS (with or without AMS). These included (1) Δ barometric pressure during ascent per hour, (2) sleepiness on rising, and (3) sleep refreshment assessed by perceived sleep quality index. Conclusion These results suggest that climbers who stay overnight at the lodge should keep a better physical condition of sleep, and would pay attention to information of barometric pressure condition to decrease their risk of AMS at the summit of Mount Fuji. Our observatory data indicated that an overnight staying in half way up to the summit does not necessarily reduce the AMS risk in both sexes and irrespective of age, at least, until 3776 m elevation.

Introduction-Annually, approximately 250,000 people climb Mount Fuji in Japan. Nonetheless, only few studies have examined the prevalence of falls and related factors on Mount Fuji.Methods-We conducted a questionnaire survey of 1061 participants (703 men and 358 women) who had climbed Mount Fuji. The following information was collected: age, height, body weight, luggage weight, experience on Mount Fuji, experience on other mountains, presence or absence of a tour guide, single-day climber or overnight-stay lodger, information on the downhill trail (volcanic gravel, long distance, and the risk of falls), presence or absence of trekking poles, shoe type, shoe sole condition, and fatigue feeling.Results-The fall rate in women (174/358; 49%) was greater than that in men (246/703; 35%). A prediction model using multiple logistic regression (no fall, 0; fall, 1) indicated that the following factors decreased the risk of falls: male sex, younger age, previous experience on Mount Fuji, having information about long-distance downhill trails, wearing hiking shoes or mountaineering boots rather than other types of shoes (eg, running shoes, sneakers) or worn-out shoes, and not feeling fatigued. Additionally, the following factors may decrease the risk of falls in women only: experience hiking on any other mountains, not being part of a guided tour, and using trekking poles.Conclusions-Women had a higher risk of falls on Mount Fuji than men. Specifically, having less experience on any other mountains, being part of a guided tour, and nonuse of trekking poles may relate to higher risks of falls in women. These results suggest that different precautionary measures for men and women are useful.

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