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Sleep apnea affects 5-10% of the general population, but some studies indicate the incidence is higher among Veterans for several reasons, including a link to PTSD-related health issues.
In fact, one study showed that nearly 70% of Iraq and Afghanistan Veterans being evaluated for PTSD had an elevated risk for sleep apnea.
Left untreated, sleep apnea can lead to several additional serious health issues such as a higher incidence of heart disease, stroke, chronic fatigue, depression and other similar conditions.
As a Veteran, if you can link your sleep apnea to a service-related cause, you may be eligible for disability benefits.
Due to the potentially serious debilitating health issues associated with sleep apnea, it’s critical for Veterans to get disability claims approved as quickly as possible.
Further complicating matters is that disability ratings are changing for 2023 as the VA learns more about sleep apnea and that makes using Veteran Ratings essential to ensure there are no delays after you submit your initial claim.
Here’s what you need to know.
Understanding Sleep Apnea and Its Impact on Veterans
Sleep apnea is a sleep disorder that occurs when a person’s breathing is interrupted while they sleep. That can happen infrequently or up to hundreds of times a night and results in the brain and a body not getting enough oxygen. That produces stress and disrupts sleep, leaving a person fatigued and unable to function fully in the morning.
Obstructive sleep apnea (OSA) is the more common form and is caused by an airway blockage usually when the soft tissue in the back of the throat relaxes and collapses during sleep. Central sleep apnea is less common and occurs when the brain fails to signal muscles to breathe due to instability in a person’s respiratory control center.
Estimates show that more than 400,000 Veterans who served after 9/11 have service-connected sleep apnea. Vietnam era Veterans also have sleep apnea in high numbers due to obesity, age, a higher incidence of smoking, PTSD, anxiety and depression. Researchers are also seeing a link between toxic exposures to Agent Orange, burn pits, and to Gulf War Syndrome.
In general, being a male or genetic factors such as a deviated septum also increase risk.
What Primary Conditions Can Cause Secondary Sleep Apnea?
Sleep apnea symptoms include:
- Loud snoring
- Gasping for air or episodes in which you stop breathing during sleep, as observed by another person.
- Morning dry mouth from breathing through your mouth instead of your nose
- Headaches when you awaken
- Nighttime insomnia
- Daytime Hypersomnia (excessive daytime sleepiness)
- Daytime lack of ability to focus, depression and irritability
Obstructive sleep apnea is more likely to occur and with greater severity when a person has large tonsils, a deviated septum, excessive weight, chronic nasal congestion, or drinks excessive amounts of alcohol.
In the long term sleep apnea might also increase the risk of recurrent heart attack, stroke, and abnormal heartbeats, such as atrial fibrillation. Heart disease can cause multiple episodes of low blood oxygen and lead to sudden death from an irregular heartbeat.
Sleep apnea is also a contributing factor for insulin resistance and Type 2 diabetes.
Sleep apnea can also lead to Metabolic Syndrome which includes high blood pressure, nonalcoholic fatty liver disease, high cholesterol and an increased waist circumference, and added complications with other medications and surgery due to sedation issues.
2023 Updates to Sleep Apnea VA Rating Criteria
In February 2022, the U.S. Department of Veterans Affairs (VA) proposed changes that would reclassify sleep apnea ratings to 0 percent, 10 percent, 30 percent, or 50 percent, with 100 percent for sleep apnea much harder to qualify for. As of May 2023, this proposed change is still under review but could have future impacts when applying for benefits.
VA Disability Rating For Sleep Apnea in 2023
Currently, the amount of disability payments you may be entitled to depend on how severe your sleep apnea is based on the VA’s evaluation. Those ratings are:
Here’s how the VA currently evaluates sleep apnea claims.
- 0% rating. A doctor has diagnosed you with sleep apnea, but it doesn’t interfere with your ability to work.
- 30% rating. You experience excessive daytime sleepiness, but don’t require a CPAP machine to help you breathe continuously at night
- 50% rating. A doctor has prescribed the use of a CPAP machine to help you get a good night’s sleep.
- 100% rating. This is reserved for the most severe complications, such as chronic respiratory failure.
The vast majority of Veterans with service-connected sleep apnea are rated at 50% and are prescribed CPAP therapy. If a clinical evaluation shows that your sleep apnea is bad enough to warrant a CPAP machine, you automatically get a 50% rating.
This is the VA’s primary plan for treating Veterans with sleep apnea but doctors will also prescribe changes in your diet and amount of exercise as well as stress reduction techniques for improved nighttime breathing.
VA Compensation For Sleep Apnea in 2023
The VA has established 2023 Veterans disability compensation rates which you can view here.
TVA disability benefits rate amounts for a single Veteran with only a sleep apnea claim above 0% would result in the following base payment amounts: (2023 rates effective as of December 1, 2022):
- 30% disability rating – $467.39/mo
- 50% disability rating – $958.44/mo
- 100% disability rating – $3,456.30/mo
At those rating levels, a Veteran is eligible for added compensation if they have a spouse, dependent children, or dependent parents. Also, if the Veteran has additional claims besides sleep apnea, those separate claims would be combined into an overall VA disability rating number that could result in higher payments.
Navigating the VA Rating Process for Sleep Apnea Claims
There are three steps in getting VA benefits for sleep apnea.
1. Receive a Sleep Apnea Diagnosis.
You must undergo a clinical sleep study that will include connecting you to diagnostic equipment to measure your sleep patterns and nighttime symptoms, including an elevated heart rate and irregular breathing.
2. Connect Your Sleep Apnea to Your Military Service.
For most Veterans, sleep apnea is a secondary condition that can be linked to a primary condition that is already service-connected. Linking secondary sleep apnea to PTSD is the most common way to connect your disability to your service.
Other ways to connect include psychiatric conditions such as anxiety, depression, substance abuse, and other trauma-related conditions. Sleep apnea that predates your enlistment can also be aggravated by a service-connected condition, making you eligible for benefits.
3. Obtain a Sleep Apnea Nexus Letter.
A doctor must certify through a nexus letter that your sleep apnea is as likely to have been caused by some service connected condition.
Documenting sleep apnea treatment of a diagnosis while in service can be challenging since most active duty personnel are taught to push through tiredness to complete their missions. Veterans are also often reluctant to seek help if they are chronically tired or have a series of poor night’s sleep. This is why linking sleep apnea to another condition from their time in the military is often the primary course of action.
After you apply for VA disability, you will receive a notification letter and a rating decision.
The letter will give a brief explanation of the VA’s decision, and if benefits are awarded, the effective date of payments.
Disability benefits decisions take approximately 6-8 months when using Veteran Ratings and our network of consulting partners to guide Veterans in gathering documents and evidence. This typically cuts the decision process time in half and possibly more versus Veterans who go through the process themselves.
