Cusco and its altitude of 11,150 ft (3,400 m) above sea level, higher than Denver Colorado, can pose a health question. Some people note shortness of breath on gathering luggage and making their way to local hotels on the hilly streets. Many travelers will find the elevation leads to some degree of acute mountain sickness (AMS), with the initial symptoms of headache, nausea, and loss of appetite beginning 4–8 hours after arrival.  The symptoms of AMS can markedly impair the traveler and prevent enjoyment of the sights of Cusco.