Sleep apnea is a common condition that affects an estimated 22 million people nationwide. If you are among former military service members living with sleep apnea, you may be eligible for veteran’s disability compensation through the Department of Veterans Affairs.
We’re seeing veterans returning from Iraq, Afghanistan and the Southwest Asian theater of war with severe sleep problems, which can often be related to post-traumatic stress disorder.
This guide will outline the basics of sleep apnea, how VA disability rating works for this condition, and how qualifying veterans can prove direct service connection as well as sleep apnea. sleep as a service-related condition secondary to PTSD.
VA diagnosis codes
Sleep apnea is classified under 38 CFR § 4.97, diagnosis code 6847 – Sleep apnea syndromes (obstructive , central mixed)
The VA assigns the following ratings to veterans based on the severity of their sleep apnea:
- 100 percent: chronic respiratory failure with carbon dioxide retention, the need for a tracheostomy, or the enlargement or failure of the right side of the heart due to lung disease. This is the most severe and highest rating available.
- 50 percent: The veteran requires the use of a breathing device, such as a CPAP machine.
- 0 per cent: The veteran’s condition does not produce any symptoms but has a documented sleep disorder. This rating is a non-compensable rating, however a veteran may be entitled to other benefits such as VA healthcare. Common problems associated with sleep apnea include increased risk of stroke, high blood pressure, memory problems, and more.
< li 30 percent: Veteran is experiencing hypersleepiness or excessive daytime sleepiness, which is not relieved by adequate sleep or even daytime naps.
Other Medical Conditions Sleep apnea is linked to
PTSD, hypertension, asthma, cardiovascular conditions, type II diabetes, mental health conditions, respiratory conditions, Alzheimer’s disease.
VA proposes changes to sleep apnea ratings
Under the current rating schedule, the VA issues ratings of 0, 30, 50, and 100 percent for sleep apnea, even if the treatments are somewhat effective in treating the condition.
However, in February 2022, the VA proposed changes that would reclassify sleep apnea ratings to 0%, 10%, 30%, or 50%, and 100% for sleep apnea seems even harder to score.
Asymptomatic sleep apnea would not compensate under tentative regulation. If the sleep apnea treatment provides only limited relief, you will only receive 10 percent of your maximum compensation, even if a CPAP machine is required.
A 50% grade will be awarded if the treatment was not effective or was unable to use therapies due to another condition. Finally, a 100% rating is available when sleep apnea is severe enough to involve organ damage.
So if this proposed change to sleep apnea ratings is approved, it is possible that veterans start receiving low grades. For now, these ratings are just a proposal, so stay tuned to this page as we update.
Veterans and Sleep Apnea
Sleep apnea is a sleep disorder potentially severe in which a person’s breathing is repeatedly interrupted, or ceases, during the course of a night’s sleep. These sleep disorders can occur tens to hundreds of times per night.
Sleep apnea symptoms are generally worse during REM sleep due to the natural reduction in muscle tone in the sleep pathways. respiratory of the body. REM (Rapid Eye Movement) sleep is also sometimes known as deep sleep. The causes of these disorders can vary depending on the form of the condition you have: obstructive, central, or a mixed form of both.
This sleep disordered breathing leads to poor quality sleep and is a risk factor for poor quality of life.
The team at Hill & Ponton can help you with a denial of benefits for sleep apnea. Click the button below for more information.
Obstructive sleep apnea (OSA) is one of the most common types of sleep apnea, which occurs when the upper airway is repeatedly blocked during the night. This blockage occurs when the muscles in the back of the throat relax, affecting airflow.
Central sleep apnea occurs when the brain does not send signals to the muscles that control sleep. breathing or those signals are interrupted. The VA refers to mixed sleep apnea as a combination of the obstructive and central forms of the condition.
Common Sleep Apnea Symptoms and Sleep Problems in Veterans
Sleep Apnea Symptoms signs and symptoms of these three types of sleep apnea tend to overlap, sometimes making it difficult to determine which type a person has.The most common symptoms include:
- Loud snoring
- Wheezing during sleep
- Waking up with a dry mouth
- Morning aches Headaches
- Insomnia
- Hypersosomnolence (excessive daytime sleepiness)
- Difficulty concentrating
Causes of sleep apnea
There are a multitude of possible causes of sleep apnea in adults, but specifically in veterans, causes could include:
- Long-term exposure to dust and fumes
- Mental anxiety and/or combat-related depression
- Weight gain
Sleep apnea risks
- Overweight
- Neck circumference
- Narrow airways
- Being male
- Being older
- Family history
- Use of alcohol, sedatives, certain medications or tranquilizers
- Smoking
- Nasal congestion
- Medical conditions
Types
- Obstructive Sleep Apnea (OSA): most form mmon, occurring when the throat muscles relax intermittently and they block the airway during sleep.
- Central sleep apnea (CSA): occurs when the brain does not send the right signals to the muscles that control breathing.
- Complex (Mixed) Sleep Apnea: occurs when someone has both central and obstructive sleep apnea.
Diagnosis
To confirm a diagnosis of sleep apnea, a sleep study must be done to show that you have breathing problems and other sleep disorders and health problems have been ruled out. To determine if you should be referred for a sleep study, a doctor will first perform a physical exam, ask about your symptoms, and take your personal and family history.
During a sleep apnea evaluation, a The doctor may ask you some of the following questions:
- Do you feel tired or sleepy during the day?
- Do you take naps? If so, how often and how long are your naps?
- Is it difficult to stay awake doing tasks like driving, reading, or watching TV?
- Do you currently smoke or have you smoked in the past?
- Has anyone in your family been diagnosed with sleep apnea?
During the exam, the doctor may also take into account your weight, neck circumference , or blood pressure (all of which could put you at higher risk of sleep apnea). Some doctors may ask you to fill out a questionnaire about your sleep habits.
Polysomnogram
A polysomnogram is a sleep study that uses medical devices to monitor breathing. , heart rate, and the electrical activity of their brain waves while they sleep. A person must have a polysomnogram, either in a sleep lab or at home, to be diagnosed with sleep apnea.
If a doctor thinks that sleep apnea is very likely, the study The sleep aid may also include a positive air pressure (PAP) device. This is called a split-night sleep study. If the results of the first half of the night confirm that you have sleep apnea, the second half of the night will use the PAP device to prepare you for ongoing treatment.
You may prefer a polysomnogram in a sleep center if you have heart or lung disease, risk factors for central sleep apnea, or a history of other sleep disorders.
VA CPAP machines for the treatment of sleep apnea
Since sleep apnea can be correlated with conditions such as disease and obesity, it is important to seek treatment options. Doctors will treat sleep apnea based on the type and severity of the condition. This can range from CPAP therapy, lifestyle changes such as diet, exercise, and others.
While some people with respiratory disorders may show improvement with lifestyle changes, respiratory assistance such as CPAP (continuous positive airway pressure) machines, BiPap machines, etc. They continue to be among the most common treatments. These machines create pressure in the airways to help a person breathe throughout the night.
Note: Millions of Philips CPAP machines have been recalled due to toxic chemicals leaking into the mask and are unknowingly inhaled by sleep apnea patients. See our Philips CPAP Retirement page here!
Establishing a Sleep Apnea Service Connection
To establish a direct sleep apnea service connection, the claimant must demonstrate that they have:
- a current diagnosis of sleep apnea
- a service event or illness/injury
- a medical nexus or link showing that the veteran’s sleep apnea is related to his or her service event, injury/illness.
A veteran may also establish a service connection for sleep apnea by secondary. This means that a veteran already has a service-connected disability that caused the veteran to have sleep apnea. In this case, there must be a medical nexus to link the sleep apnea to your already service-connected disability.
Some conditions that may be secondary to sleep apnea may include, but are not limited to:
- heart conditions
- mental health conditions
- diabetes
If you have a service-connected condition that you think is causing your sleep apnea, it may be a good idea to start talking to your doctors about it.
C&P sleep apnea exam and sleep studies
The VA will generally order a sleep study to confirm a current diagnosis of sleep apnea. As part of VA’s duty to help veterans obtain evidence to help prove their claim, VA has a duty to help veterans schedule a sleep study exam and help them make a VA disability claim. to which they are entitled.
This study will serve as medical evidence for the veteran’s case and can help prove the medical condition(s) that go into a total score.
What happens during an exam? C&P for sleep apnea?
During a C&P exam for sleep apnea, you will be asked questions about your condition and how it affects your daily life. You may also be asked to fill out what is called a Disability Benefits Questionnaire or DBQ. The DBQ allows an examiner in a C&P exam to check the boxes next to the descriptions that best express how your sleep apnea is affecting you. Being honest and thorough is important so everything can be properly documented. It may also help to bring someone with you to the appointment.
Sleep Apnea Reexams
Sometimes the VA will schedule reexams to determine if there has been improvement with a la Veterans’ sleep apnea has improved. If so, there could be a rating reduction. However, there are several rules that must be followed for this to occur:
- The proposed score must be based on the complete medical history
- It must show that there has been an improvement in the veterans functionality
If the VA proposes a rating reduction, then the veteran can present an argument against it.
In addition, there are some cases where the VA will not you can schedule Retests:
- If you are over 55
- If you have a score that has stayed the same for more than five years (stabilized)
- If you have a total disability score, that is, a score of 100 percent
- You have a permanent disability
If you are interested in learning more about the exams C&P, See Check Out Our Guide!
How do I prove VA disability for sleep apnea?
Medical evidence and documented medical records will be needed from a C&P exam from VA for the filing process of your claim and may even disclose other secondary conditions. A C&P examination and a diagnosis of sleep apnea are crucial to qualifying for the higher levels of compensation.
Believe it or not, statements from friends can be helpful in proving sleep apnea claims if you can find Veterinarians you have worked with. and heard you snore, or you can talk about the issues that led to your sleep apnea. Loved ones, such as family or close friends, could also be a great help in sharing how your sleep has changed.
How hard is it to get a VA disability for sleep apnea?
For veterans who have already been diagnosed with sleep apnea without a VA sleep study, the veteran may be required to have a VA sleep study to confirm the diagnosis for medical purposes. of benefits. The medical exam may seem like extra hard work, but it could qualify that veteran for additional monthly compensation.
Sleep Apnea and PTSD-Related Symptoms
Research has demonstrated that combat veterans with PTSD PTSD, also known as PTSD, may be at higher risk of sleep apnea than the general population. There are overlapping risk factors in both disorders that affect sleep apnea and PTSD symptoms, often exacerbating the conditions.
Although all of these symptoms contribute to the interplay between sleep apnea and PTSD, the main culprits seem to be lack of sleep and chronic stress. Studies have shown that veterans with these symptoms tend to have a higher frequency and duration of apnea episodes than can be verified by a medical professional.
See our post on sleep apnea’s secondary connection to PTSD here!
Why would a VA sleep apnea claim be denied?
VA can deny a sleep apnea claim based on different things, whether there is not enough medical evidence of sleep apnea or there may not be a logical connection between your military service and your current sleep apnea. If your VA obstructive sleep apnea or other sleep apnea claim was originally denied, you may be able to appeal the rating and receive VA disability compensation.
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