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How to Describe Hypersomnolence at a Disability Hearing

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How Can You Receive VA Disability for Sleep Apnea?

Sleep apnea is a common condition that affects about 22 million people nationwide. If you are among the former military service members living with sleep apnea, you may be eligible for veterans disability compensation through the Department of Veterans Affairs.  We're seeing veterans coming back from Iraq, Afghanistan, and the southwest Asia theater of war with severe sleep issues, which can often times be linked to PTSD. This guide will outline the basics of sleep apnea, how the VA disability rating works for this condition, and how qualifying veterans can prove service connection. We'll also talk a bit about PTSD's link with sleep apnea.

What Is Sleep Apnea?

Sleep Apnea is a potentially serious sleep disorder in which a person's breathing is repeatedly interrupted, or ceases, during the course of a night's sleep. These sleep disturbances can occur from tens to hundreds of times per night. Typically, sleep apnea symptoms are at their worst during REM Sleep due to the body's naturally-occurring reduced muscle tone in the body's airway. REM (Rapid Eye Movement) sleep is also sometimes known as deep sleep. The causes of these disturbances may vary depending on which form of the condition you have: obstructive, central, or a mixed form of both. This sleep-disordered breathing leads to poor sleep quality and is a risk factor for poor quality of life.

Obstructive sleep apnea (OSA) is one of the more common types of sleep apnea, which occurs when the upper airway repeatedly becomes blocked throughout the night. This blockage is caused when the back throat muscles relax, impairing the airflow. Central sleep apnea occurs when the brain either does not send signals to the muscles that control 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 and Sleep Problems Symptoms in Veterans

Some of the most common symptoms of sleep apnea include:

  • Episodes in which you stop breathing during sleep — which another person would notice and report
  • Gasping for air while sleeping
  • Loud snoring
  • Waking up with a dry mouth
  • Morning headaches
  • Difficulty staying asleep (insomnia)
  • Excessive daytime sleepiness (hypersomnia)
  • Difficulty paying attention while awake
  • Irritability

Veterans who are experiencing the above symptoms should consider seeking a diagnosis and pursuing sleep apnea disability benefits. This generally requires a sleep study. If left untreated, sleep apnea can lead to conditions like:

  • High blood pressure (hypertension)
  • Stroke
  • Heart failure, irregular heartbeats, and heart attacks
  • Diabetes
  • Depression
  • Worsening of ADHD
  • Headaches

Positive Airway Pressure Therapy for Sleep Apnea Treatment

Since sleep apnea can correlate with conditions like heart disease and obesity, it's important to seek treatment options. Physicians will treat sleep apnea depending on the type and severity of the condition. This can range from CPAP therapy, lifestyle changes such as diet, exercise, and others. While some individuals with breathing disorders may show improvement from lifestyle changes, breathing assistance devices such as CPAP machines (Continuous Positive Airway Pressure), BiPap machines, etc. are still among the most common treatments. These machines creates airway pressure to help the individual breathe throughout the night.

va disability sleep apnea

How VA Rates Sleep Apnea

TheVA disability ratings for sleep apnea are based on the severity of the veteran's Obstructive Sleep Apnea. Sleep apnea is rated under 38 CFR § 4.97, Diagnostic Code 6847. This diagnostic code falls under the Sleep Apnea Syndromes. The VA assigns the following ratings for 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 the highest rating available.
  • 50 percent: the veteran requires the use of a breathing device, such as a CPAP machine.
  • 30 percent: the veteran is experiencing hypersomnolence, or excessive daytime sleepiness, that does not improve with sufficient sleep or even with naps during the day.
  • 0 percent: 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 health care.
    Common issues associated with Sleep Apnea include increased risk of stroke, high blood pressure, memory problems, and more.

Establishing Service Connection For Sleep Apnea

Eligibility for veterans benefits depends on proving service connection. In order to establish direct service connection for sleep apnea, a claimant must show that they have a current, diagnosis of sleep apnea, an in-service event or illness/injury, and a medical nexus or link that shows the veteran's sleep apnea is related to their in-service event, injury/illness.

A veteran can also establish service connection for sleep apnea on a secondary basis. This means that a veteran has an already 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 their already service-connected disability. Some conditions that can be secondary to sleep apnea may include but are not limited to heart conditions, mental health conditions, and diabetes. If you have a service-connected condition that you believe is causing your sleep apnea, it may be a good idea to start to talk to your doctors about it.

How Does the VA Diagnose Sleep Apnea?

The VA will usually order a sleep study to be performed in order to confirm a current diagnosis of sleep apnea. As a part of the VA's duty to assist veterans in obtaining evidence to help prove their claim, the VA has a duty to assist veterans in scheduling the examination for a sleep study. This study will serve as medical evidence for the veteran's case.

For veterans who have already been diagnosed with sleep apnea without a sleep study by the VA, the veteran may have to undergo a sleep study done by the VA in order to confirm the diagnosis for benefit purposes.

Linked Sleep Apnea and PTSD Symptoms

Research has shown that combat veterans with post-traumatic stress disorder, also known as PTSD, may be at higher risk for sleep apnea than the general population. There are risk factors that overlap in both disorders affecting sleep apnea and symptoms of PTSD, often times aggravating the conditions. Some of these factors are issues that military personnel may have frequently experienced while deployed overseas in active duty or other combat-related duties, such as disturbed sleep in combat, excessive sleep deprivation, sleep fragmentation, hyperarousal, and chronic stress.

Although all of these symptoms contribute to the interaction between sleep apnea and PTSD, the main culprits seem to be sleep deprivation and chronic stress. Studies have shown that war veterans exhibiting these symptoms tend to have increased frequency and length of apneic events.

PTSD Risk Factors

Research has also shown there is a high risk of sleep apnea when a patient's PTSD symptom severity follows a worsening trend. Because of the interplay between the shared factors of the two disorders,  development of PTSD after a traumatic event may be a decent predictor of sleep impairment and potentially apneic events. Sleep apnea and other mental disorders are also associated with each other. Clickhere to learn more about that topic.

The important takeaway message is that if you are a veteran suffering from PTSD, it is important to get a screening for sleep apnea. You may be eligible for additional VA disability benefits based on that diagnosis.

Denied Sleep Apnea Benefits?

If your obstructive sleep apnea VA claim, or other sleep apnea claim, was originally denied, you may be able to appeal the rating and receive VA disability compensation. Contact our team by pressing the button below!

How to Describe Hypersomnolence at a Disability Hearing

Source: https://www.hillandponton.com/how-the-va-rates-obstructive-sleep-apnea/