What Causes Asthma & Sleep Apnea in Our War Veterans?

Posted by Berry Law on November 14, 2022 in Sleep Apnea

Many Veterans experience asthma, while others experience sleep apnea. However, plenty of Veterans experience both conditions simultaneously. 

Although asthma and sleep apnea are often considered separate medical conditions, they can aggravate each other. Asthma can also cause sleep apnea.

If you experience symptoms of asthma and/or sleep apnea, you might qualify for an increased disability rating and further benefits from the VA. Today, we’ll explore what causes asthma and sleep apnea in Veterans like you.

What Is Asthma?

Asthma is a potentially serious lung condition. When you have asthma, your airways could become narrow, swollen, and/or inflamed when exposed to certain stimuli or at certain times. Alternatively, your airways might fill with extra mucus.

Regardless, asthma is characterized by difficulty breathing and ancillary symptoms like wheezing, coughing, chest pains, and more. Asthma can be infrequent or regular and must be managed accordingly.

While you can be born with a risk of developing asthma, asthma is often triggered, aggravated, or caused by exposure to certain inhaled chemicals or toxins. Some individuals also have seasonal asthma driven by exposure to pollen and other common allergens.

What Is Sleep Apnea?

Sleep apnea is a serious sleep disorder separated into three distinct types:

• Obstructive sleep apnea occurs if your throat muscles relax too much, pressing on your airways and preventing you from inhaling properly.
• Central sleep apnea occurs if your brain doesn’t send the correct signals to your body’s lungs and nervous system to continue breathing while asleep.
• Complex or mixed sleep apnea occurs if you have symptoms from both obstructive and central sleep apnea.

No matter which type of sleep apnea you experience, the symptoms are similar: difficulty breathing consistently while asleep, resulting in interrupted sleep cycles, fatigue during the day, and other long-term and negative complications.

Sleep apnea can develop randomly, but it can also be triggered, aggravated, or caused by many roots. These include exposure to toxic chemicals, brain damage, respiratory disease, and PTSD. 

Service Connections for Asthma

The VA rates all bronchial asthma according to Diagnostic Code 6602. Your disability rating under this code can vary based on which type of asthma disability you experience.

The VA uses Forced Expiratory Volume (FEV) to determine an accurate disability rating for your symptoms. The FEV essentially measures how much you can exhale when you breathe forcefully. 

You can receive a service connection for your asthma symptoms under the following percentages:

• 10% disability rating if your bronchial asthma causes an FEV or Forced Vital Capacity (FCV) value between 71% and 80% of expected values or if you require the intermittent use of an inhalational, anti-inflammatory medication
• 30% rating if your bronchial asthma results in an FEV or FCV value of 56% to 70% of expected values, if you need daily oral or inhalational bronchodilator therapy, or if you need to regularly use inhalational anti-inflammatory medication
• 60% rating if your bronchial asthma results in an FEV or FCV value of 40% to 55% of expected values, if you have to visit your physician at least once a month for an asthma attack, or if you take three courses or more of systemic corticosteroids per year to manage your asthma symptoms
• 100% rating if your bronchial asthma results in an FEV or FVC value of less than 40% of the expected value or if you have more than one asthma attack each week. You may also receive a 100% rating if you suffer regular episodes of respiratory failure, if you take systemic corticosteroids, or if you take medications like high-dose corticosteroids or immune-suppressive medications to manage your asthmatic symptoms

Service Connections for Sleep Apnea

The VA rates sleep apnea according to 38 CRF 4.97 Diagnostic Code 6847. The code includes all sleep apnea syndromes, including obstructive, central, and mixed sleep apnea. The VA may assign you a rating from 0% to 100% depending on the severity of your condition and related symptoms:

• 0% disability rating if you have a documented sleep disorder like sleep apnea but are asymptomatic
• 30% rating if you have hypersomnolence or excessive chronic daytime sleepiness
• 50% rating if you require the use of a CPAP machine or other breathing assistance device
• 100% rating if your sleep apnea requires a tracheostomy or if it results in chronic respiratory failure, including chronic carbon dioxide retention

Note that a 100% disability rating for sleep apnea symptoms is rare, although it is possible.

How Are Asthma and Sleep Apnea Related?

According to a recent study, individuals who suffer from asthma are more likely to develop obstructive sleep apnea. The same study found a 40% risk of developing sleep apnea for individuals with asthma compared to individuals without asthmatic symptoms.

There are many potential reasons for this connection. For example, obstructive sleep apnea often occurs in individuals whose airways become inflamed or otherwise blocked. Because asthma sometimes causes the buildup of excess mucus, this may lead to obstructive sleep apnea symptoms since the airways become blocked due to asthma.

Inhalers and other oral or inhaled bronchodilators may also lead to or aggravate sleep apnea symptoms. Specifically, these can cause upper airway muscles to weaken or degrade, which may prevent them from functioning properly when breathing while asleep.

Because there is an obvious medical connection between asthma and sleep apnea, Veterans who suffer from both may be able to prove that their service caused or aggravated the symptoms of the other. This may result in a higher disability rating and more benefits over time. 

Your lawyer can advise you on the best path forward to maximizing your benefits by providing ample medical evidence establishing a medical nexus between your sleep apnea or asthma and your military service.

How Sleep Apnea May Affect Your Disability Rating

Since sleep apnea can be caused by asthma, you may receive a secondary disability service connection from the VA if your asthma was caused or aggravated by your time in the military.

Secondary service connections are awarded to Veterans who experience symptoms or illnesses that only arose due to their primary, service-connected conditions or illnesses. For example, if your service-connected asthma causes you to develop or aggravates your sleep apnea symptoms, you may be able to establish service connection on a secondary basis.

This may result in a combined disability rating. However, a combined disability rating doesn’t mean that you add two disability ratings together for a new total. Instead, the secondary disability rating applies as a percentage to your primary or current disability rating.

Suppose you have a current disability rating of 30% because of your asthma symptoms. You contact a medical expert and prove the medical nexus between your service-connected asthma and your new sleep apnea symptoms. You then receive a sleep apnea rating of 50%.

To find your combined disability rating, you find 50% of your current 30% rating. That’s 15%. Add 15% to the 30% current disability rating, and you’ll find a new total disability rating of 45%.

Veterans law attorneys can help you grasp the complexities of a combined disability rating and help you maximize your benefits.

Contact Veterans Law Attorneys Today

All Veterans deserve the maximum disability benefits they can receive for their service-related conditions and illnesses. If you currently receive disability benefits for asthma or sleep apnea but you experience the symptoms of both conditions, you could qualify for a higher disability rating.

Berry Law can help you get that rating when you contact us today. As experienced Veterans law attorneys, we know the ins and outs of the application process and can help you apply for a higher disability rating by proving how your asthma and sleep apnea are related, both to each other and to your time in the military.

Sources:

What Is Sleep Apnea? | NHLBI, NIH

What Is Asthma? | NHLBI, NIH

38 CFR § 4.97 – Schedule of ratings – respiratory system. | CFR | US Law | LII / Legal Information Institute

38 CFR § 4.97 – Schedule of ratings – respiratory system. | CFR | US Law | LII / Legal Information Institute

Obstructive Sleep Apnea Syndrome and Asthma: What Are the Links? – PMC | NCBI