Could easily be just dehydration.
That’s what I’m wondering... Has he been on the campaign trail a lot lately? (I’ve been “heads down” at work too much to notice) If he’s been spending a lot of time on airplanes that could be a contributing factor. Aircraft are typically only pressurized to the equivalent of about 10,000 ft altitude, and the air is notoriously dry in them. He could be dehydrated, and suffering mild altitude sickness. Living in Colorado - at about 7100 ft - I’ve seen it, particularly when “flatlanders” come out to go skiing. Most of the resorts are at 10K ft plus... Heck, Monarch sits right on the continental divide...