VA Compensation for Sleep Apnea

Sleep Apnea Explained

Sleep apnea is a sleep disorder that comes in three primary types. This potentially serious disorder causes the sufferer’s breathing reflex to repeatedly stop and start again, leading to respiratory issues. The primary types of sleep apnea are:

• Obstructive sleep apnea, which is a common condition suffered by veterans. This occurs when throat muscles relax, blocking the airway
• Central sleep apnea. This occurs when your brain doesn’t send the right signals to the muscles responsible for the breathing reflex
• Complex sleep apnea syndrome, also called treatment-emergent central sleep apnea. This occurs when an individual has both central sleep apnea and obstructive sleep apnea

Obstructive sleep apnea, the most common type experienced by veterans, can be dangerous because relaxed throat muscles block the airway during sleep. This causes sudden and potentially serious issues, as the body cannot fully relax or sink into a deep sleep and must constantly adjust itself to breathe.

Veterans may experience sleep apnea due to many reasons, such as neurological or physical damage that they may have suffered during their service. Other veterans may suffer from sleep apnea due to complications or side effects from medication.

Symptoms of Obstructive Sleep Apnea

Obstructive sleep apnea is characterized by several symptoms. These include:

• Very loud and incessant snoring
• Excessive sleepiness in the daytime hours – this can occur if sleep apnea disrupts your sleep cycles
• Having a dry mouth or sore throat when you awaken
• Abruptly awakening multiple times in the night
• Morning headaches
• Lack of breathing while you sleep – someone else, like a partner, might notice this
• Higher than average blood pressure
• Mood changes including depression or irritability
• Difficulty concentrating during the rest of the day

At first, it can be difficult to notice the signs of sleep apnea as opposed to other disorders or conditions since it shares symptoms with other problems. The best way to tell if you have obstructive sleep apnea is to record yourself while you sleep if you live alone, or to have someone who lives with you watch you while you rest.

They will be able to tell whether you stop breathing or snore as a result of an obstructed airway, either of which may be a serious sign of sleep apnea.

How Does the VA Rate Sleep Apnea? 

As with all other disabilities, the VA rates sleep apnea on a scale from 0% to 100%. 0% ratings indicate that there are no major symptoms, even if the sleep disorder is documented.

• 0% – a veteran may still receive some benefits, including VA healthcare, even if their sleep apnea does not produce any other physical symptoms
• 30% – this rating indicates that the veteran experiences hypersomnolence, also called excessive daytime sleepiness. This condition must not improve with sufficient sleep or naps during the daytime to qualify
• 50% – this rating indicates the veteran requires a CPAP machine or another breathing device 
• 100% – this rating indicates that the veteran is experiencing chronic respiratory failure due to carbon dioxide retention. They may also need a tracheostomy, and the right side of their heart may fail or enlarge because of the condition affecting their lungs

All sleep apnea ratings are documented under Diagnostic Code 6847. As with all other VA disability ratings, you will be eligible for more benefits and financial assistance with a higher rating.

How to Get VA Compensation for Sleep Apnea

It can be difficult to acquire disability assistance for sleep apnea complications if you don’t know where to start.

For you to be eligible for VA disability for your sleep apnea, you must prove that your service is directly connected to your current condition. A VA disability claimant must show:

• That they have a current medical diagnosis of sleep apnea
• That during their service there was an event, including an illness or an injury, that occurred and formed a medical nexus or link to the sleep apnea

In other words, the claimant must show that something during their service directly contributed to or caused the sleep apnea, and they must be currently suffering from sleep apnea on a regular basis.

Note that veterans can use a secondary basis to establish a service connection to their sleep apnea. Put another way, if a veteran has another service-connected disability already, they may be able to prove that the first disability is now contributing to or causing the second sleep apnea disability. Various conditions that qualify under VA codes for disability can also qualify as a secondary basis, including:

• Mental health conditions such as PTSD
• Heart conditions
• Diabetes
• And more

Above all else, it’s important to talk to your doctor if you believe that your sleep apnea was caused by a service-connected condition. They will be able to examine your condition’s symptoms and determine whether there is evidence of a medical nexus somewhere in your service record.

How Can PTSD Cause Sleep Apnea?

Although PTSD may seem to be a separate condition, there is evidence that PTSD itself can place veterans at higher risk for sleep apnea. This is due to multiple factors that overlap between the disorders, which can aggravate or exaggerate one another.

For example, many veterans experience disturbed sleep patterns, high amounts of sleep deprivation, hyperarousal, chronic stress, and fragmented sleep during their active duty. Because of these factors, sleep apnea may develop as a result or be exaggerated if it existed prior to military service.

In fact, there is evidence to suggest that sleep deprivation and chronic stress are the two primary factors that contribute to or cause sleep apnea. Furthermore, other research shows that more severe cases of PTSD are also associated with a greater likelihood of developing sleep apnea if the veteran did not have the condition before.

All in all, PTSD and sleep apnea are connected enough that many veterans are able to draw a clear medical connection between the two conditions and receive appropriate benefits.

What’s Involved with VA Sleep Apnea Diagnoses?

The VA will typically require that you submit to a sleep study to confirm that you are currently experiencing sleep apnea. Fortunately, as part of the VA’s duty to assist veterans as they try to obtain evidence to prove a claim, the VA also has a duty to assist you in scheduling the sleep study examination.

The sleep study can serve as the medical evidence or basis for your case. You can contact your local VA office and set up a scheduled time and place for your sleep study that works best for your needs.

If you have already been diagnosed with sleep apnea but haven’t undergone a sleep study, you’ll still need to undergo a study explicitly ordered by the VA in most cases. The sleep study must be documented by the VA for your condition to qualify for benefits.

Sources:

https://www.ptsd.va.gov/publications/rq_docs/V27N4.pdf

https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090

https://www.sleepapnea.org/why-our-veterans-cant-sleep/#:~:text=All%20forms%20of%20sleep%20apnea,the%20result%20of%20substance%20abuse.