Build a high-altitude itinerary around where you will sleep each night and what you can change if the route stops going to plan. A CDC sleeping-elevation figure can help review an itinerary, but it is not a safety guarantee. This worksheet compares options to wait, descend, or seek local help; it is not a personal medical assessment.

A conceptual mountain itinerary with sleeping elevations rising in stages and a planned acclimatization stop

Record each night’s sleeping elevation separately

Create one row per travel day. Record the date, overnight location, and elevation where you expect to sleep. Put the highest daytime point, transfer method and duration, and next overnight stop in separate fields. This keeps a daytime visit to a high pass followed by sleep at lower lodging distinct from moving to a higher place to sleep. A single summit number can conceal a sequence of rising nights.

A sample row could read: “Day 4 / sleep at 3,200 m / daytime high point 3,700 m / return to lodging at 2,800 m / two-hour vehicle transfer.” These numbers only demonstrate the format; they do not describe a recommended or verified safe route. For an actual trip, check elevations against a reliable map or local source, then confirm that lodging and transport operate on the dates you need them.

Compare the planned route with a hold and a lower option

If the only written plan is to continue as scheduled, reservations and a summit deadline can become the decision rule by default. Put at least three options side by side. The planned option lists overnight stops and transfers. A hold option names a place to stay an extra night, whether a room and supplies are available, and how to contact companions or local support. A changed-route option records transport back, a lower place to sleep, a rendezvous point, and cancellation or rebooking deadlines.

The CDC Yellow Book describes a common planning approach above 3,000 m: limit increases in sleeping elevation to about 500 m per day and include a day without a higher sleeping elevation every three to four days. Wilderness Medical Society (WMS) Winter Conference 2024 teaching slides cover similar staged-ascent points for education. Both sources qualify the figures by starting elevation, terrain, and individual susceptibility. Use them to compare plans and prepare questions, not as an automatic pass/fail rule or a guarantee that a route is safe.

Mark decision points and confirm the contact route

Choose a place on each segment where the group can pause before committing to the next overnight elevation. Check whether roads are open, whether a vehicle or public transport actually runs, and whether a lower lodging option can be reached before nightfall. In remote areas, map distance may understate the time needed for transport or medical help, so verify local operating conditions.

The worksheet can name who communicates a route change, how companions can reach that person, which local medical or emergency contact is relevant, and what to try if the first channel fails. Confirm before departure that the number or communication method works at the destination. Add practical constraints such as lodging cancellation deadlines, park or border hours, and fuel stops; they determine whether an alternative exists in reality. These are operational route details, not medical findings.

Reopen the overnight plan when health or access changes

The CDC Yellow Book discusses symptoms that may occur at altitude, including headache and nausea, as well as serious warning features such as confusion, difficulty walking, or breathlessness at rest. A list cannot diagnose a traveler or establish that continuing is safe. If someone becomes unwell, use the contact route in the plan and reassess the next sleeping-elevation gain alongside options to wait or descend. Actual response should follow current local medical or emergency instructions and qualified judgment.

Track health changes separately from weather and transport disruptions. A closed road or unavailable lodging may make the planned transfer impossible even when nobody reports symptoms; illness may require a change while transport is running normally. Naming the next decision point and alternative place to sleep makes both types of change visible before a reservation or timetable removes practical options.

Expert perspective: keep the figures subordinate to route choices

The CDC Yellow Book says itinerary planning cannot eliminate altitude illness and individual responses vary. The WMS item cited here is a Winter Conference 2024 teaching lecture, not the Society’s formal clinical practice guideline. Its figures are educational planning material, not a rule that certifies a traveler or route as safe. The worksheet’s value is not to label a route “safe”; it is to compare sleeping elevations night by night and preserve a real option to wait, descend, or seek local help when conditions change.

Sources: CDC Yellow Book, High-Altitude Travel and Altitude Illness, Wilderness Medical Society Winter Conference 2024, Foundations in Wilderness Medicine: Altitude Illness — teaching slides