As a veteran, you may have experienced the physical and emotional toll of combat or other service-related injuries. And if you’re dealing with sleep apnea secondary to PTSD, you know how challenging it can be to manage both conditions.
But the good news is that a growing body of research supports the link between Post Traumatic Stress Disorder or PTSD and sleep apnea, and with the right approach, you can prove your compensation claim and get the support you need to manage your health and well-being.
In this article, we’ll explore the link between the two conditions, the steps you can take to prove your claim, and the importance of seeking timely treatment so at the end you will be able to get the VA benefits you have earned.
Understanding Sleep Apnea
It’s the middle of the night, and you wake up gasping for air again. Your life partner, used to your condition, shakes you awake and reminds you to put on your mask. But despite breathing again, you can’t shake the nagging feeling that your situation is more than just a physical ailment. After all, you’re a veteran with PTSD and know all too well how interconnected your physical and mental health can be.
In simple terms, sleep apnea is when a person’s breathing repeatedly stops and starts during sleep. This can happen dozens of times per hour, significantly impacting a person’s ability to get a restful night’s sleep.
There are three primary types of sleep apnea:
- Obstructive Sleep Apnea: This is the most prevalent form. In this type, the throat muscles relax and obstruct the airway, causing a person to stop breathing.
- Central Sleep Apnea: This is less common and occurs when the brain signals responsible for controlling breathing muscles aren’t functioning correctly.
- Complex or Mixed Sleep Apnea: This form combines obstructive and central sleep apnea.
There can be other causes too. For example, a recent study cited by The International Tinnitus Journal shows that sleep disturbances associated with tinnitus found 69% of patients also experienced poor sleep quality. Consequently, you may be able to establish a nexus for sleep apnea secondary to tinnitus.
Regardless of the type, service connected sleep apnea can lead to a range of symptoms, including loud snoring, gasping or choking during sleep, headaches, and excessive daytime sleepiness. It can also lead to severe health problems with high risk factors like high blood pressure, heart disease, heart attack or heart failure and stroke.
Based on a study, individuals with PTSD are 2.7 times more likely to suffer from sleep apnea compared to those without PTSD, which means veterans are at a higher risk of developing sleep apnea secondary to PTSD. While this statistic does not guarantee that a veteran’s disability is directly linked to PTSD, it can provide helpful insights.
To establish a service connection, veterans must submit medical records and other evidence that validates the relationship between the two conditions. Similar research conducted by the Walter Reed Army medical center revealed that almost all of the 80 OIF/OEF veterans or those who served in Iraq and Afghanistan diagnosed with PTSD had sleep problems, and nearly two-thirds had sleep apnea, significantly higher than the national frequency.
Nonetheless, at present, no definitive or scientific evidence links the two conditions definitively. Some people may naturally develop sleep apnea due to aging, body changes, or weight gain.
How Do Sleep Disorders Impact Veterans?
According to a July 2021 study published in the Journal of Clinical Sleep Medicine, veterans at risk for cardiovascular disease often suffer from undiagnosed or undertreated sleep disorders. The study, which included 420 veterans, revealed that over half (52.1%) of participants screened positive for sleep apnea. Additionally, many veterans also experience insomnia.
A report published in the journal SLEEP found that in a study of more than 5,500 post-9/11 veterans, 57.2% had insomnia—a much higher rate than the general population of around 30%. The study also found that veterans with conditions such as PTSD, traumatic brain injury, and chronic pain had even higher rates of insomnia.
It’s not just younger veterans who struggle with sleep problems; older veterans may experience long-term problems dating back to their military service. While sleep problems are common among veterans, they can be effectively treated with help from a primary care doctor at Veterans Affairs or an accredited sleep center.
The Connection Between PTSD and Sleep Apnea
So, what does sleep apnea have to do with PTSD? Could your diagnosis be secondary to PTSD? It turns out that the two conditions are often intertwined, and studies have shown that people with PTSD are at a higher risk of developing sleep apnea and vice versa.
One reason for this link is that PTSD can cause changes in the nervous system, affecting breathing patterns during sleep. For example, the body’s natural “fight or flight” response, triggered by traumatic experiences, can cause shallow breathing and other disruptions leading to sleep apnea.
In addition, the symptoms of PTSD, such as hypervigilance and nightmares, can also contribute to developing symptoms. For example, people with PTSD may be more likely to sleep in a position that worsens their breathing problems or avoid sleep altogether due to fear of nightmares or flashbacks.
C&P Exam for Sleep Apnea Secondary To PTSD
A Compensation and Pension (C&P) exam is a crucial step in the process of applying for disability compensation. A C&P exam is a medical evaluation conducted by a healthcare provider the VA contracts to assess the nature and extent of your medical condition. This exam provides the VA with additional medical evidence to support your claim and help them make a decision about your disability compensation. Remember, the PTSD symptoms are not what they will be focusing on but do you meet the VA criteria for a sleep apnea rating.
During a C&P exam for a sleep apnea secondary to PTSD VA rating, the healthcare provider will likely ask questions about your symptoms and medical history. They may also perform a physical exam and order and review additional tests, such as a sleep study or a respiratory assessment, to help determine your REM sleep and the severity of your disability. If you have a CPAP machine they will also review the data collected.
It’s important to note that the C&P exam is not the only factor the VA considers when deciding your compensation claim. They will also consider other medical evidence, such as your medical records and the opinions of other medical professionals who have treated you.
Proving Your Sleep Apnea Claim
So, if you suspect your sleep apnea is related to PTSD, how do you prove it to the VA? The key is to gather as much medical evidence as possible to support your claim. It is a good idea to have a sleep study conducted prior to submission. If the study indicates you need a CPAP machine then make sure to submit it as medical evidence.
But how do you go about proving the connection between the two conditions? The key is to gather as much medical evidence as possible to support your claim, as outlined in the VA’s Disability Benefits Questionnaire (DBQ).
This process begins with obtaining a formal diagnosis of both conditions from a qualified medical professional, such as a physician or psychiatrist. From there, you’ll need to provide evidence that shows a clear link between the two conditions, including medical records and expert opinions.
Working with a Veterans Service Officer (VSO) can also help gather evidence and navigate the appeals process if needed. By following the guidelines for completing the DBQ for sleep apnea secondary to PTSD and seeking assistance, you can increase your chances of obtaining the compensation you deserve.
Requirements for a Sleep Apnea VA Rating
Under Diagnostic Code 6847, also known as sleep apnea syndromes, the VA rates and evaluates the disease based on its severity and symptoms, ranging from 0% to 100%.
A 0% rating means a veteran qualifies for no disability benefits, although standard benefits such as healthcare may be available. On the other hand, a rating of 100% allows a veteran to claim total disability and receive the highest possible monthly compensation.
- A rating of 0% is given for asymptomatic sleep apnea or documented sleep-disordered breathing.
- A rating of 30% is given to Veterans who experience persistent daytime hypersomnolence.
- A rating of 50% is given to Veterans who have to use a Continuous Positive Airway Pressure (CPAP) machine or other breathing assistance device.
- A rating of 100% is only given to Veterans who experience chronic respiratory failure with “carbon dioxide retention or cor pulmonare” or Veterans who require a tracheostomy.
Summary
If you’re a veteran with PTSD symptoms and sleep apnea, it’s essential to understand the link between these two conditions and to take the necessary steps to prove your compensation claim and get VA benefits. By gathering medical evidence, seeking timely treatment, and working with a VSO, you can improve your chances of success and get the support you need to manage your health and quality of life.
FAQs
What is the VA disability rating for sleep apnea secondary to PTSD?
The VA rating for this disorder varies depending on the severity of the condition and its impact on the individual’s ability to function. The rating can range from 0% to 100%, with higher ratings indicating more significant impairment and eligible for higher compensation.
What are the symptoms of sleep apnea secondary to PTSD?
Sleep apnea symptoms secondary to PTSD can include loud snoring, gasping or choking during sleep, interruptions in breathing, difficulty falling asleep or staying asleep, sleep deprivation and daytime fatigue. Other symptoms may include headaches, dry mouth, excessive weight gain and irritability.
What can sleep apnea be claimed secondary to?
Sleep apnea can be claimed secondary to various conditions, including PTSD, obesity, sinusitis, deviated septum, and other respiratory diseases.
Do I need a nexus letter for sleep apnea secondary to PTSD?
No, a nexus letter connecting sleep apnea to PTSD is sometimes needed for a successful compensation claim with the VA. This letter should come from a qualified medical professional and clearly explain the relationship between the two conditions. A well written personal statement in support of claim will be equally as benefical as a nexus letter.