Sleep is a precious commodity for military service members. Most understand what it feels like to be so tired to be able to sleep in almost any place regardless of comfort or noise. This begins in most military indoctrination programs and carries through in later active service as a necessary part of mission accomplishment. It is therefore an unfortunate consequence of military service that so many veterans have sleep disorders.
One such disorder is sleep apnea. Sleep Apnea is a serious condition where breathing is interrupted repeatedly during sleep. Obstructive Sleep Apnea is most common where muscles of the throat relax causing blockage of the airways. Central Sleep Apnea is another type where the signals from the brain are interrupted and cause breathing to stop for short periods. And when the two disorders are present in one patient, it is called Mixed or Complex Sleep Apnea. Regardless of the type, these syndromes can cause significant issues during daytime hours with fatigue, sleepiness, headaches, irritability, and difficulty concentrating.[1]
For reasons not fully understood, Sleep Apnea in veterans has a strong correlation to veterans with gulf war era service from 1990 to the present.[2] Strong links have been shown to exist to mental health disorders like PTSD even when typical community risk factors like obesity and age were not present.[3]
These conditions are not presumptive so a veteran must obtain this rating by individually applying to the VA for service-connected disability. Remember that to obtain service-connected disability the veteran must show 1) a current disability, 2) an occurrence of an injury or event while in service, and 3) a nexus or link between the current disability and that in-service event. It could also be recognized as a secondary condition.
The ratings for Sleep Apnea can be found in the regulations under respiratory conditions at 38 CFR 4.97 and the diagnostic code of 6847 for “Sleep Apnea Syndromes”. Here is the scale with some added links for additional information:
6847 Sleep Apnea Syndromes (Obstructive, Central, Mixed):
100% – Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requires tracheostomy. See here for the the Cor Pulmonale Definition.
50% – Requires use of breathing assistance device such as continuous positive airway pressure (CPAP) machine. This is a device that keeps your airways open. This CPAP Machine Article explains how it works.
30% – Persistent day-time hypersomnolence. This comes in varying degrees but happens to a person with feelings of sleepiness during waking hours. Here is a link to Hypersomnolence Article explaining what it is.
0% – Asymptomatic but with documented sleep disorder breathing.
Regardless of the outcome of a veteran’s disability application, Sleep Apnea is a treatable condition and often results in reducing other chronic illnesses associated with it. Veterans who believe they have this condition should expect to take part in an overnight sleep study with a test called polysomnography to help medical professionals understand the underlying causes.[4]
Finally, the evidence required for this condition is often best gathered from buddy statements from roommates, partners and friends in and out of service because they are the ones most likely disturbed from your snoring or stoppages of breathing during the night. A well written buddy statement or lay statement would include an accurate description of symptoms observed. According to the Mayo Clinic, some of the symptoms your spouse, bunkmates, or friends might have witnessed would include:
- Loud Snoring
- Episodes in which your breathing stops during sleep
- Gasping for air during sleep
- Awakening with a dry mouth
- Morning Headache
- Difficulty staying asleep (insomnia)
- Excessive daytime sleepiness (hypersomnia)
- Irritability[5]
Regardless of the severity of your symptoms, you deserve a good night’s sleep after so many years of service whereby you could rarely find one in the midst of high operational tempo or combat.
[1] https://www.merckmanuals.com/home/lung-and-airway-disorders/sleep-apnea/sleep-apnea
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909622/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410924/
[4] https://www.merckmanuals.com/home/lung-and-airway-disorders/sleep-apnea/sleep-apnea
[5] https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631