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Academic Journal of Humanities & Social Sciences, 2023, 6(24); doi: 10.25236/AJHSS.2023.062420.

The Effect of High Altitude on Emotion and its Physiological Mechanism


Jing Fan

Corresponding Author:
Jing Fan

School of Education, Tibet University, Lhasa, 850000, China


Experienced emotional discomfort as negative, depressive mood increase and positive mood reduce has been observed after long-term exposure to high altitude (HA). Scientists have found it can be affected through sleep, however few studies found it to have no relations with sleep at high altitude, so this study intends to find out whether sleep quality play its role in emotion variation of long-term migrants to HA, and whether the oxygen-carrying capacity can influence the possible effect of sleep quality on emotions. Maximal oxygen uptake (VO2max) was measured and the participants also completed questionnaires including Pittsburgh Sleep Quality Index (PSQI), Positive and Negative Affect Scale (PANAS), Patient Health Questionnaire-9 items (PHQ-9) and Generalized Anxiety Disorder Questionnaire (GAD-7). The analysis of 105 health participants, who resided at a high altitude (3,680m) for more than 2 years showed that sleep quality is associated with depression mood and VO2max can moderate the relationship between them, with sleep can better influence depression within individuals with lower VO2max. These results indicate that oxygen carrying capacity can influence emotion through sleep, offer insights of emotion intervention at HA.


High altitude, Emotion, Sleep quality, Maximal oxygen uptake, Depression

Cite This Paper

Jing Fan. The Effect of High Altitude on Emotion and its Physiological Mechanism. Academic Journal of Humanities & Social Sciences (2023) Vol. 6, Issue 24: 119-127. https://doi.org/10.25236/AJHSS.2023.062420.


[1] Bahrke, M. S., & Shukitt-Hale, B. (1993). Effects of Altitude on Mood, Behaviour and Cognitive Functioning. Sports Medicine, 16(2), 97–125. https://doi.org/10.2165/00007256-199316020-00003/

[2] Aquino Lemos, V., Antunes, H. K. M., Santos, R. V. T., Lira, F. S., Tufik, S., & Mello, M. T. (2012). High altitude exposure impairs sleep patterns, mood, and cognitive functions. Psychophysiology, 49(9), 1298–1306. https://doi.org/10.1111/j.1469-8986.2012.01411.x

[3] Legg, S., Gilbey, A., Hill, S., Raman, A., Dubray, A., Iremonger, G., & Mündel, T. (2016). Effects of mild hypoxia in aviation on mood and complex cognition. Applied Ergonomics, 53, 357–363. https://doi.org/10.1016/j.apergo.2015.10.002

[4] Gao, Y. X., Li, P., Jiang, C. H., Liu, C., Chen, Y., Chen, L., Ruan, H. Z., & Gao, Y. Q. (2014). Psychological and cognitive impairment of long-term migrators to high altitudes and the relationship to physiological and biochemical changes. European Journal of Neurology, 22(10), 1363–1369. https://doi.org/10.1111/ene.12507

[5] Zaeh, S., Miele, C. H., Putcha, N., Gilman, R. H., Miranda, J. J., Bernabe-Ortiz, A., Wise, R. A., & Checkley, W. (2016). Chronic respiratory disease and high altitude are associated with depressive symptoms in four diverse settings. The International Journal of Tuberculosis and Lung Disease, 20(9), 1263–1269. https://doi.org/10.5588/ijtld.15.0794

[6] Kious, B. M., Bakian, A., Zhao, J., Mickey, B., Guille, C., Renshaw, P., & Sen, S. (2019). Altitude and risk of depression and anxiety: findings from the intern health study. International Review of Psychiatry, 31(7–8), 637–645. https://doi.org/10.1080/09540261.2019.1586324

[7] Sabic, H., Kious, B., Boxer, D., Fitzgerald, C., Riley, C., Scholl, L., McGlade, E., Yurgelun-Todd, D., Renshaw, P. F., & Kondo, D. G. (2019). Effect of Altitude on Veteran Suicide Rates. High Altitude Medicine & Biology, 20(2), 171–177. https://doi.org/10.1089/ham.2018.0130

[8] Fan Wanlin, Wang Xin, He Yuxin et al. (2020) Effect and Mechanism of Chronic Intermittent Hypoxia on Depression in Rats with Obstructive Sleep Apnea Hypopnea Syndrome [J]. Chinese Journal of Clinical Psychology, 28(3), 445-449. DOI:10.16128/j.cnki.1005-3611.2020.03.003.

[9] Kamdar, B. B., Kaplan, K. A., Kezirian, E. J., & Dement, W. C. (2004). The impact of extended sleep on daytime alertness, vigilance, and mood. Sleep Medicine, 5(5), 441–448. https://doi.org/10.1016/j.sleep.2004.05.003

[10] Blaxton, J. M., Bergeman, C. S., Whitehead, B. R., Braun, M. E., & Payne, J. D. (2015). Relationships Among Nightly Sleep Quality, Daily Stress, and Daily Affect. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, gbv060. https://doi.org/10.1093/geronb/gbv060

[11] Çelik, S., Genç, G., Kinetli, Y., Aşılıoğlı, M., Sarı, M., & Madenoğlu Kıvanç, M. (2016). Sleep problems, anxıety, depressıon and fatıgue on famıly members of adult intensıve care unıt patıents. International Journal of Nursing Practice, 22(5), 512–522. https://doi.org/10.1111/ijn.12451

[12] Bloch, K. E., Buenzli, J. C., Latshang, T. D., & Ulrich, S. (2015). Sleep at high altitude: guesses and facts. Journal of Applied Physiology, 119(12), 1466–1480. https://doi.org/10.1152/japplphysiol.00448.2015

[13] Sakamoto, R., Okumiya, K., Norboo, T., Tsering, N., Yamaguchi, T., Nose, M., Takeda, S., Tsukihara, T., Ishikawa, M., Nakajima, S., Wada, T., Fujisawa, M., Imai, H., Ishimoto, Y., Kimura, Y., Fukutomi, E., Chen, W., Otsuka, K., & Matsubayashi, K. (2017). Sleep quality among elderly high-altitude dwellers in Ladakh. Psychiatry Research, 249, 51–57. https://doi.org/10.1016/j.psychres.2016.12.043

[14] Feng, J., Wu, Q., Zhang, D., & Chen, B. Y. (2012). Hippocampal impairments are associated with intermittent hypoxia of obstructive sleep apnea. Chinese medical journal, 125 (04), 696-701. DOI:10.3760/cma.j.issn.0366-6999.2012.04.025.

[15] de Aquino-Lemos, V., Santos, R. V. T., Antunes, H. K. M., Lira, F. S., Luz Bittar, I. G., Caris, A. V., Tufik, S., & de Mello, M. T. (2016). Acute physical exercise under hypoxia improves sleep, mood and reaction time.Physiology & Behavior, 154, 90–99. https://doi.org/10.1016/j.physbeh.2015.10.028

[16] XU, C., LIU, S., KONG, Z., & CHEN, N. (2016). Sleep architecture, periodic breathing and mood disturbance of expeditioners at Kunlun Station (4087 m) in Antarctica. Advances in Polar Science. 

[17] Zhao, F., Yang, J., & Cui, R. (2017). Effect of Hypoxic Injury in Mood Disorder. Neural Plasticity, 2017, 1–10. https://doi.org/10.1155/2017/6986983

[18] Erdi, P., Huhn, Z., & Kiss, T. (2005). Hippocampal theta rhythms from a computational perspective: code generation, mood regulation and navigation. Neural networks,18(9), 1202-1211. https://doi.org/10.1016/j.neunet.2005.08.001.

[19] Wilson, M. H., Newman, S., & Imray, C. H. (2009). The cerebral effects of ascent to high altitudes. The Lancet Neurology, 8(2), 175–191. https://doi.org/10.1016/s1474-4422(09)70014-6

[20] MUKAIMOTO, T., UEDA, H., HAN, I. Y., SENBA, S., & OHNO, M. (2010). CHANGES IN CEREBRAL OXYGENATION DURING A SINGLE BOUT OF COMBINED CIRCUIT TRAINING. Japanese Journal of Physical Fitness and Sports Medicine, 59(5), 529–540. https://doi.org/10.7600/jspfsm.59.529

[21] Albinet, C. T., Mandrick, K., Bernard, P. L., Perrey, S., & Blain, H. (2014). Improved cerebral oxygenation response and executive performance as a function of cardiorespiratory fitness in older women: a fNIRS study. Frontiers in Aging Neuroscience, 6. https://doi.org/10.3389/fnagi.2014.00272

[22] Goldstein, A. N., & Walker, M. P. (2014). The Role of Sleep in Emotional Brain Function. Annual Review of Clinical Psychology, 10(1), 679–708. https://doi.org/10.1146/annurev-clinpsy-032813-153716

[23] Palmer, C. A., & Alfano, C. A. (2017). Sleep and emotion regulation: An organizing, integrative review. Sleep Medicine Reviews, 31, 6–16. https://doi.org/10.1016/j.smrv.2015.12.006

[24] Sibille, E., Morris, H. M., Kota, R. S., & Lewis, D. A. (2011). GABA-related transcripts in the dorsolateral prefrontal cortex in mood disorders. International Journal of Neuropsychopharmacology, 14(6), 721–734. https://doi.org/10.1017/s1461145710001616

[25] de Geus, E. J., van Doornen, L. J., & Orlebeke, J. F. (1993). Regular exercise and aerobic fitness in relation to psychological make-up and physiological stress reactivity. Psychosomatic Medicine, 55(4), 347–363. https://doi.org/10.1097/00006842-199307000-00003

[26] Osei-Tutu, K. B., & Campagna, P. D. (2005). The effects of short- vs. long-bout exercise on mood, VO2max., and percent body fat. Preventive Medicine, 40(1), 92–98. https://doi.org/10.1016/j.ypmed.2004.05.005

[27] Solianik, R., & Sujeta, A. (2018). Two-day fasting evokes stress, but does not affect mood, brain activity, cognitive, psychomotor, and motor performance in overweight women. Behavioural Brain Research, 338, 166–172. https://doi.org/10.1016/j.bbr.2017.10.028

[28] Martin, D., & O’Kroy, J. (1993). Effects of acute hypoxia on the VO2max of trained and untrained subjects. Journal of Sports Sciences, 11(1), 37–42. https://doi.org/10.1080/02640419308729961

[29] Bailey, D. M., Brugniaux, J. V., Filipponi, T., Marley, C. J., Stacey, B., Soria, R., Rimoldi, S. F., Cerny, D., Rexhaj, E., Pratali, L., Salmòn, C. S., Murillo Jáuregui, C., Villena, M., Smirl, J. D., Ogoh, S., Pietri, S., Scherrer, U., & Sartori, C. (2018). Exaggerated systemic oxidative‐inflammatory‐nitrosative stress in chronic mountain sickness is associated with cognitive decline and depression. The Journal of Physiology, 597(2), 611–629. https://doi.org/10.1113/jp276898