Short answer
Lhasa sits at 3,650 metres. The airport is around 3,570 metres and the monasteries sit higher. At that height there is roughly a third less oxygen per breath than at sea level, and the body needs three to five days to adjust properly.
Most visitors get some version of acute mountain sickness in the first 24 hours: headache, tiredness, poor sleep, mild nausea. It usually settles within 12 to 48 hours if you do not go higher and do not push yourself. The people who get into trouble are the ones who treat arrival day as a sightseeing day.
Rest on day one, drink more water than feels necessary, skip alcohol and heavy meals, and keep the first 48 hours physically light. Oxygen is available at hotels and pharmacies for genuine symptoms. Two symptoms are not negotiable: breathlessness while sitting still, and confusion or an unsteady walk. Both mean medical help immediately, not more rest.
What altitude actually does
Air at 3,650 m contains the same share of oxygen, but each breath delivers fewer oxygen molecules because the pressure is lower. The body's response in the first days is to breathe faster and deeper, raise heart rate and shift fluid balance. That adaptation is the acute phase of acclimatisation, and it takes three to five days.
Two things do not help. Making red blood cells takes weeks, not days, so it plays no part in the first stretch. And acclimatisation earned at one altitude does not carry you to a higher one, which is why a day trip to a 4,900 m lake is a different proposition from a day in Lhasa.
| Place | Altitude | What it means |
|---|---|---|
| Lhasa city | ~3,650 m | Sleeping altitude for the whole city stay |
| Gonggar Airport | ~3,570 m | One of the highest civilian airports in the world |
| Drepung Monastery | ~3,700 m plus hillside climb | The walk up is the demanding part |
| Tanggula Pass, by rail | 5,072 m | Crossed in a pressurised carriage, usually at night |
| Yamdrok Lake | ~4,441-4,990 m | A day trip that spends hours well above Lhasa |
| Everest Base Camp | ~5,200 m | A multi-day trip with its own acclimatisation needs |
How altitude sickness feels
Acute mountain sickness is the ordinary version. Symptoms usually start two to twelve hours after arrival, often during or after the first night, and the classic set is headache, fatigue, dizziness, nausea and a broken night's sleep.
| Symptom | Common at this altitude | Response |
|---|---|---|
| Headache | Very common | Water, rest, a painkiller. Persistent severe headache needs more than that. |
| Tiredness, breathlessness on stairs | Normal | Slow down. Stairs are the standard test. |
| Broken sleep, waking short of breath | Common | Periodic breathing at night is normal. Symptoms easing by day three usually mean things are working. |
| Nausea, loss of appetite | Common | Eat light and carbohydrate-heavy. Noodles and rice digest with less oxygen demand than heavy protein meals. |
| Breathlessness at rest | Not normal | Medical help. This is a warning sign for fluid in the lungs. |
| Confusion, unsteady walk, vomiting that will not stop | Not normal | Emergency. Tell your guide and get to a hospital. |
The condition generally resolves in 12 to 48 hours if you stay at the same altitude and keep activity low. Going higher while symptomatic is what turns a bad day into a serious one.
Day one, hour by hour
The first day is the whole game. Arriving off a flight from Chengdu means stepping out at 3,650 m with no adjustment at all, and the stress on the body takes several hours to show up.
- Get to the hotel and stop movingNo sightseeing on arrival day, even if you feel fine. Lie down for several hours. Adrenaline from the trip masks symptoms for the first stretch.
- Drink, then drink moreBreathing fast in very dry air loses water quickly. Three to four litres across the day is the usual guidance.
- Eat light and earlyCarbohydrate-heavy food, modest portions. Overeating at altitude makes nausea worse.
- Skip the first-night showerHot water opens blood vessels, raises heart rate and drops blood pressure, and cooling down afterwards invites a cold. This is standard advice from Tibet operators, and the risk is highest on the first night.
- No alcohol for the first 48 hoursAlcohol slows breathing and dehydrates. Sleeping tablets and sedatives have the same problem, because breathing already drops during sleep.
- Sleep propped up if the night is roughSleeping slightly elevated and keeping the room warm helps. If a regular caffeine habit exists, keep it going, because a caffeine withdrawal headache reads exactly like an altitude headache.
Day two is for short, flat walks: the Barkhor circuit, the Jokhang, a tea house. Day three is when the Potala stairs and the monastery hillsides make sense. Put Drepung, with its genuine climbing, on day three or later.
Prevention that works
- Ascend gradually if the schedule allows. The train from Xining takes around 21 hours and climbs in stages, crossing Tanggula Pass in a pressurised, oxygen-enriched carriage. Flying in is faster and harder on the body.
- Hydrate and eat carbohydrates. The two most repeated pieces of advice from people who live there.
- Ask a travel doctor about acetazolamide before you fly. Diamox is the medication with the best evidence for speeding acclimatisation, with typical preventive dosing in published guidance at 125 mg twice daily starting one to two days before ascent. It is a prescription drug, it is a sulfonamide, and it is not suitable for everyone. A doctor decides this, not a website.
- Treat supplements as supplements. Some travellers take Rhodiola in the week before arrival. Evidence is weaker than for acetazolamide, and it does not replace rest.
- Insure for altitude. Standard policies often exclude high-altitude rescue and evacuation. Check that the policy explicitly covers it.
Oxygen, and how to use it
Oxygen is widely available and cheap in Lhasa. Cans from city pharmacies run about ¥20-50, and the same can costs more at scenic sites. Many hotels supply room oxygen, oxygen bags at reception, or cylinders for rent. Confirm what your hotel offers at check-in rather than at three in the morning.
How it is used matters. For mild discomfort, rest and hydration do the work, and routine oxygen use is generally discouraged because it can slow the body's own acclimatisation. For a genuine symptom that is not settling, oxygen is the right tool. Ask the guide before improvising.
When to stop treating it yourself
Lhasa has real hospitals, including Lhasa People's Hospital and the Tibet Autonomous Region hospital system, and altitude illness is routine there. The Lhasa railway station has a passenger health centre with round-the-clock staff offering blood pressure checks, oxygen and basic medication. See the healthcare guide for how hospitals and payment work in China.
Things people get wrong
- Feeling fine means nothing yet. Symptoms often arrive hours after arrival, and the first night is the usual trigger.
- Altitude sickness is not a fitness test. Marathon runners get it and unfit people sometimes do not. There is no reliable way to predict who reacts.
- Going higher to escape it does the opposite. If symptoms are getting worse, the treatment is descent or medical care, not a trip to a higher lake.
- Overusing oxygen can work against acclimatisation. Save it for real symptoms.
- Sunburn and dehydration land harder here. UV index runs very high from April to September, and the dry air strips moisture from skin and airways.
Frequently asked questions
How high is Lhasa, and how bad is it?
Lhasa city sits at about 3,650 metres, the airport at around 3,570 metres. Most visitors get mild symptoms in the first day, usually headache and poor sleep, and they settle in one to two days with rest. Serious altitude illness is uncommon at this height but it does happen, and it is more likely in people who ignore day one.
Should I take Diamox?
Acetazolamide has the strongest evidence for speeding acclimatisation, with typical preventive dosing quoted at 125 mg twice daily starting a day or two before ascent. It requires a prescription and is not suitable for everyone, including people with a sulfonamide allergy. Ask a travel medicine doctor before the trip rather than deciding on the plane.
Can I shower on the first day in Lhasa?
The standard advice from Tibet operators is to skip the first-night shower and often hair-washing for the first few days. Hot water dilates blood vessels, raises heart rate and can drop blood pressure, and cooling down afterwards invites a cold, which is harder to recover from at altitude. It is a comfort sacrifice rather than a hard rule, but the first night is the riskiest one.
Is alcohol really off the table?
For the first 48 hours, yes. Alcohol depresses breathing and dehydrates, both of which work against acclimatisation, and sleeping tablets and sedatives carry the same problem. After a couple of days, in moderation, most people are fine.
Do I need oxygen in Lhasa?
Not routinely. Hotels and pharmacies sell cans for around ¥20-50, and many hotels provide room oxygen or bags. For mild symptoms, rest and water usually do the job. Oxygen is for genuine symptoms that are not settling, and the guide should be told either way.
Can children or older travellers visit Lhasa?
There is no fixed age limit, but the response to altitude varies by individual and cannot be predicted from age or fitness. Families with young children and travellers with heart, lung or sleep conditions have a conversation with a doctor before booking, and insurance covering high-altitude evacuation matters more in these cases, not less.
Related reading
Altitude figures for Lhasa, Gonggar Airport and the Tanggula Pass follow published transport and CDC high-altitude travel data. Acclimatisation timelines, symptom onset and medication dosing follow the CDC Yellow Book high-altitude guidance and Wilderness Medical Society ascent recommendations. This is general travel information, not medical advice, and individual risk factors belong with a doctor.