Sleep Apnea Secondary to PTSD
Many veterans, especially those who were deployed in combat, report sleep disturbances, flashbacks, nightmares, and trouble breathing while asleep after they have retired from service. It’s very common for veterans to develop disabling post-traumatic stress disorder, or PTSD, from their service. Many veterans with PTSD also suffer from related sleep apnea.
- Veterans with PTSD are at a significantly higher risk of developing sleep apnea, with studies showing a strong correlation between the two conditions.
- The VA allows veterans to claim sleep apnea as a secondary disability to PTSD, potentially increasing their overall disability rating and benefits.
- To qualify for a secondary disability rating, veterans must provide medical evidence linking their sleep apnea to their service-connected PTSD.
If you sustained disabling PTSD and sleep apnea as a result of your military service, you may receive a VA disability rating and qualify for benefits. If you’ve already been approved for benefits for PTSD but have since developed sleep apnea stemming from your PTSD, you may be eligible to apply for a secondary disability rating and qualify for additional benefits.
How To Show the VA Your Sleep Apnea Is Caused by PTSD
To receive a secondary disability rating for sleep apnea, you must prove you have a current diagnosis of sleep apnea that stems from service-connected PTSD. You must file VA Form 21-526EZ, which can be done online, by mail, or in person at your local VA office.
Just like when you originally filed for VA disability benefits, you must provide evidence with your application for the secondary condition. This evidence typically includes documents and records such as the following.
Medical Records
You will need to submit copies of your medical records demonstrating that you have both sleep apnea and PTSD.
Sleep Studies
Sleep studies are not required to apply for secondary condition benefits. However, if you’re applying for a secondary rating for sleep apnea, sleep studies demonstrating sleep apnea symptoms are extremely helpful in proving your claim.
Nexus Letter
A nexus letter is crucial to a successful VA claim. It is written by a doctor who has treated you directly and comprehensively examined your files. The nexus letter establishes a link between your primary and secondary conditions and connects both to your military service. Nexus letters are not mandatory, but many denials result from lacking or inadequate nexus letters.
C&P Exam Results
The Compensation and Pension exam, or C&P exam, is a medical examination requested by the VA and performed by a VA medical professional. The VA usually requests these exams in cases where there are discrepancies in your medical record or the agency needs additional verification of the claims. While the VA gives C&P results significant weight, the exam will not be the sole basis for approval or denial.
Personal Statements
Personal statements, sometimes called “buddy letters,” from people who know you and see you in your day-to-day life can be a helpful part of a benefits application. The personal statement is a VA affidavit of facts, Form 21-4138, supporting your disability claim written by a layperson, like a friend or family member.
How To Make a Secondary Claim for Sleep Apnea to PTSD
If you believe you qualify for a secondary sleep apnea claim related to an already approved claim for PTSD, Veterans Guide can help. We can connect you with knowledgeable and experienced advocates who can help you navigate the VA’s claims process and give you the best chance at approval.
Contact us today online or by phone at 888-982-1009 for a free case evaluation.
Relationship of Sleep Apnea and PTSD in Veterans
Post-traumatic stress disorder, or PTSD, is a psychiatric condition resulting from trauma. It is extremely common for veterans returning from service, particularly those who have served in combat. PTSD can be a severely disabling disorder, and many veterans with PTSD struggle to reintegrate into civilian life after discharge.
Symptoms of PTSD include the following:
- Intrusive thoughts, like nightmares or flashbacks
- Avoidance of other people
- Negative thoughts and moods, like hopelessness and depression
- Emotional changes, like paranoia, self-destructive behavior, and inability to focus
Sleep apnea is a respiratory disorder that restricts the ability to breathe through the nose and mouth while asleep. The condition can cause sleep disturbance, insomnia, gasping for air during sleep, daytime fatigue, and episodes where breathing stops briefly and restarts while asleep. While sleep apnea is often caused by exposure to toxic chemicals, asthma, and other service-connected physical conditions, it can also be linked to psychiatric disabilities like depression and PTSD.
Sleep apnea and PTSD are frequently related conditions for veterans. The link between PTSD and sleep apnea is well-established by medical studies of veterans screened for both conditions. One study found that 63 percent of veterans with PTSD displayed symptoms of sleep apnea, which appeared in only 7 percent of veterans without PTSD. The VA recognizes sleep apnea is a common secondary disorder for those with an existing PTSD rating.
Despite the medical evidence of a connection between PTSD and sleep apnea, the exact cause of the connection is unknown. The conditions are believed to be bidirectional, exacerbating each other in a kind of vicious cycle. PTSD may cause or exacerbate sleep apnea with nightmares, which result in sleep disturbance and may escalate into sleep apnea. Meanwhile, sleep apnea’s impact on good sleep slows recovery time for PTSD. Sleep interruptions caused by waking up from PTSD nightmares can worsen PTSD by disturbing the body’s ability to heal the traumatic memories associated with the condition.
Because veterans experience high statistical rates of PTSD, they are more likely to be affected by sleep apnea, as well. Lack of sleep and frequent disruption caused by intrusive thoughts related to PTSD significantly impact veterans’ quality of life, resulting in isolation from their communities, the inability to hold jobs, and loss of interest in their daily activities. In extreme cases, PTSD can lead to suicide.
How Are PTSD and Sleep Apnea VA Ratings Combined?
It’s not uncommon for veterans to develop multiple disabilities as a result of their service. In some cases, one service-related condition may be caused by another. When this occurs, the VA combines disability ratings for both conditions to compensate veterans appropriately for their disabilities.
The VA has a specific system for combining disability ratings. Rather than simply adding the two percentages, the VA uses a formula to determine what your total rating for multiple disabilities should be. To see how the VA combines ratings, check out our VA disability rating calculator
For PTSD, the possible disability ratings are 100, 70, 50, 30, and 10 percent, with 70 percent being the most common. For sleep apnea, possible ratings are 100, 50, 30, and 0 percent, with common ratings ranging from 30 to 50 percent.
For example, according to the way the VA combines ratings, a veteran with a
70 Percent
PTSD Rating
and a
30 Percent
Sleep Apnea Rating
would have a combined rating of 79 percent, which would then be rounded up to 80 percent.
50 Percent
PTSD Rating
and a
50 Percent
Sleep Apnea Rating
would be combined for 75%, which would be rounded up to 80% total.
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