Sleep Apnea VA: Understanding Disability Benefits for Veterans as of July 2025

Sleep apnea affects many veterans, often as a result of their military service. This common sleep disorder causes breathing pauses during sleep, which can lead to serious health issues when left untreated. The VA rates sleep apnea under Diagnostic Code 6847 with disability ratings ranging from 0% to 100%, with veterans requiring a CPAP machine typically receiving a 50% disability rating. 

To qualify for VA disability benefits for sleep apnea, you need to demonstrate that your condition is service-connected, meaning it began in service, was caused by some exposure in service, or was secondary to another service-connected condition. This process involves gathering medical evidence, service records, and sometimes buddy statements that can help establish the connection between your military service and your sleep apnea diagnosis.

Understanding the VA rating criteria is crucial as you navigate your claim. With potential changes coming to sleep apnea ratings in 2025, staying informed about how the VA evaluates this condition can help you receive the benefits you deserve.

Key Takeaways

• VA disability ratings for sleep apnea range from 0% to 100% based on severity and required treatment methods.
• You must establish service connection by providing medical evidence linking your sleep apnea to military service.
• Proper documentation, including sleep study results and ongoing treatment records, strengthens your VA disability claim.

Understanding Sleep Apnea and Its Impact on Veterans

Sleep apnea is a serious sleep disorder that affects many veterans and can significantly impact their quality of life and overall health. Veterans face unique risk factors that make them more susceptible to developing this condition compared to the general population.

Types of Sleep Apnea

There are three main types of sleep apnea that veterans may experience:

1. Obstructive Sleep Apnea (OSA) – The most common type, occurring when throat muscles relax and block your airway during sleep. This blockage causes breathing pauses that can happen 5-30 times per hour.
2. Central Sleep Apnea (CSA) – This occurs when your brain doesn’t send proper signals to the muscles that control breathing. Unlike OSA, there’s no physical blockage, but rather a communication problem.
3. Complex Sleep Apnea – Also called treatment-emergent central sleep apnea, this combines aspects of both OSA and CSA. Some veterans initially diagnosed with OSA develop central apnea symptoms when using CPAP treatment.

Each type requires different treatment approaches, making proper diagnosis crucial for effective management. We notice that a lot of doctors will just call all sleep apnea “OSA” – without regard to whether the records show central apneas. But if you look at your sleep study, it should detail the type or types of sleep apnea you experience.

Prevalence Among Veterans

Sleep apnea affects veterans at significantly higher rates than the civilian population. Studies show that approximately 20% of veterans have been diagnosed with sleep apnea, compared to about 5% of the general population.

Several factors contribute to this higher prevalence:

• Combat exposure and PTSD
• Military-related injuries
• Higher rates of obesity among veterans
• Exposure to environmental hazards during service

Veterans who served in Iraq and Afghanistan show particularly high rates of sleep apnea. This may be linked to burn pit exposure and other environmental factors unique to these deployments.

The condition is also more common in veterans with service-connected mental health conditions like depression and anxiety, creating a complex cycle where sleep problems and mental health issues worsen each other. The literature technically connects the condition to PTSD, but by extrapolating the literature it can be possible to show a likely connection to anxiety and depression too.

Symptoms and Health Risks

Recognizing sleep apnea symptoms early can lead to better outcomes. Common signs include:

• Loud, chronic snoring
• Witnessed breathing pauses during sleep
• Excessive daytime sleepiness (hypersomnolence)
• Morning headaches
• Difficulty concentrating
• Irritability and mood changes

If left untreated, sleep apnea can lead to serious health complications. Veterans with untreated sleep apnea face increased risks of:

• Cardiovascular problems (high blood pressure, heart attack, stroke)
• Type 2 diabetes
• Liver problems
• Metabolic syndrome

The condition can also worsen existing mental health conditions. Many veterans report improved PTSD symptoms after treating their sleep apnea, highlighting the interconnected nature of these conditions.

Service Connection and Eligibility for VA Benefits

Veterans who suffer from sleep apnea may qualify for VA disability benefits if they can establish a connection between their condition and military service. The VA offers ratings of 0%, 30%, 50%, or 100% depending on severity and required treatment.

Establishing Service-Connection

To receive VA disability benefits for sleep apnea, you must prove the condition is connected to your military service. This can be done in three main ways:

Direct Service Connection:

• Your sleep apnea began during active duty
• Medical records show diagnosis or symptoms while in service
• You have a current diagnosis from a qualified medical professional

Secondary Service Connection:

• Your sleep apnea developed due to another service-connected condition
• Common related conditions include PTSD, anxiety, depression, and certain physical injuries
• Obesity (BMI over 30) can be an intermediary cause – meaning, your service-connected injury caused you to gain weight, and that in turn, caused you to develop sleep apnea

Aggravation:

• A pre-existing sleep disorder worsened beyond normal progression during service

Medical evidence is crucial. Sleep studies, doctor’s opinions, and buddy statements from fellow service members can strengthen your claim. The VA denied 76% of sleep apnea appeals in recent years, so thorough documentation is essential.

Impact of Comorbid Conditions

Sleep apnea often occurs alongside other conditions that can affect your VA disability claim and overall rating.

Mental Health Connections:

• PTSD can increase sleep apnea risk by 4-5 times
• Anxiety and depression often disrupt sleep patterns
• Chronic insomnia disorder frequently overlaps with sleep apnea*

*While the actual mechanisms that link mental health conditions to sleep apnea are not fully understood, one theory is that neurological changes from certain mental conditions can impact the brain’s ability to regulate breathing while you sleep.

Physical Health Factors:

• Weight gain from service-connected conditions may contribute to sleep apnea
• Medications for service-connected conditions can worsen sleep disorders
• Chronic fatigue and sleep disturbances may indicate undiagnosed sleep apnea

When filing a disability claim, you should document how these comorbid conditions interact with your sleep apnea. This comprehensive approach can lead to more accurate ratings and better reflect your total disability picture.

The VA recognizes these relationships, making it possible to claim sleep apnea secondary to other conditions you’re already service-connected for.

Proving Obesity as an Intermediary Cause

When claiming sleep apnea secondary to weight gain from a service-connected condition, the VA requires you to meet a specific three-part test. Understanding this analysis can help strengthen your claim and ensure you provide the right medical evidence.

Part 1: Service-Connected Condition Caused Weight Gain You must show that your service-connected disability directly led to obesity or made existing weight problems worse. Medical records should document this progression clearly.

Common examples include:

• A back injury that limits mobility and exercise capacity
• Knee or hip conditions that prevent physical activity
• Mental health conditions that lead to medication-induced weight gain
• PTSD or depression causing changes in eating habits or activity levels

Part 2: Obesity Substantially Contributed to Sleep Apnea The evidence must demonstrate that your weight gain played a significant role in developing sleep apnea. Your medical records should show this connection, not just mention both conditions separately.

Look for documentation that specifically links your weight to breathing problems during sleep. Sleep study results may note how excess weight affects your airway function.

Part 3: The “But For” Test This final part asks: Would you have developed sleep apnea if not for the obesity caused by your service-connected condition? Medical opinions addressing this question can be crucial for your claim’s success.

Your doctor’s nexus letter should address all three parts of this analysis. Simply stating that obesity can cause sleep apnea isn’t enough – the medical evidence must trace the specific chain from your service-connected condition to weight gain to sleep apnea development.

Gathering comprehensive medical records that document this progression over time strengthens your case significantly. Treatment notes showing how your service-connected condition affected your ability to maintain a healthy weight provide valuable supporting evidence.

Qualifying Sleep Disorders for VA Disability

The VA recognizes several sleep disorders for disability benefits, with sleep apnea being among the most common.

Types of Sleep Apnea Covered:

• Obstructive Sleep Apnea (OSA) – most common form
• Central Sleep Apnea – neurological in nature
• Complex/Mixed Sleep Apnea – combination of both types

VA Rating Structure:

• 100%: Chronic respiratory failure with carbon dioxide retention or cor pulmonale; or requires tracheostomy
• 50%: Requires use of CPAP machine
• 30%: Persistent daytime sleepiness
• 0%: Asymptomatic but documented sleep disorder

Other qualifying sleep disorders include chronic insomnia disorder, narcolepsy, and other sleep-related breathing disorders. The VA evaluates these conditions based on how they impact your daily functioning and ability to work.

More than 500,000 veterans received benefits for sleep apnea in 2022, making it one of the most common conditions in the VA disability system.

Filing a Sleep Apnea VA Disability Claim

Successfully filing a VA disability claim for sleep apnea requires proper documentation and understanding the VA’s requirements. Getting the right medical evidence and following the correct submission process can significantly improve your chances of approval.

Required Medical Evidence

To file a successful sleep apnea VA disability claim, you must have a formal diagnosis based on a sleep study. This is non-negotiable – the VA will not grant claims without this specific medical evidence.

Important note: Sometimes, if you provide enough evidence to suggest you might have sleep apnea, but you have not had a formal sleep study performed, VA will conduct a sleep study as part of its evaluation of your claim. It is important to realize that if VA sends you for a sleep study as part of the Compensation and Pension exam process, the doctors are evaluating you, and are not technically treating you. So if VA does diagnose you with sleep apnea, you need to follow up with your treating doctors to determine the right kind of treatment, and ask if you need a CPAP machine or other treatment device.

Your claim must also establish a service connection. This means proving your sleep apnea either:

• Started during your military service
• Was caused by an in-service event or injury
• Was worsened due to military service

A nexus letter from your doctor is crucial. This medical opinion links your condition to your military service. The letter should clearly explain how your service activities or environment contributed to your sleep apnea.

Medical records showing ongoing treatment are also valuable. Keep documentation of CPAP machine use, doctor visits, and any medications prescribed for your condition.

The Claim Submission Process

You can file your disability claim online through the VA’s website using Form 21-526EZ. This is typically the fastest method for submission.

Before starting your application, gather all your documentation:

• Medical records with sleep apnea diagnosis
• Service treatment records
• Nexus letter from your doctor
• Lay statements from yourself and others

The VA will review your claim and may schedule a Compensation and Pension (C&P) exam. This assessment helps determine your disability rating, which affects your compensation amount.

Be prepared to complete a Sleep Apnea Disability Benefits Questionnaire as part of your claim. This form captures specific details about your condition and its severity.

Common Pitfalls and How to Avoid Them

Missing or incomplete medical evidence is the most common reason claims get denied. Always include a formal sleep study, if you can,  showing your diagnosis and severity level. Don’t rely solely on symptoms or a doctor’s opinion without the supporting sleep study.

Failing to establish service connection is another frequent issue. You need to clearly connect your sleep apnea to your military service. Lay statements from fellow service members who witnessed your symptoms during service can strengthen this connection. A medical opinion letter is especially important if you developed sleep apnea after service, and think it was caused by one of your service-connected conditions.

Many veterans underestimate the importance of medical treatment consistency. Gaps in treatment may suggest your condition isn’t severe or continuous. Maintain regular doctor visits and follow prescribed treatments.

Missed deadlines can derail your claim. The VA has strict timelines for appeals and responding to requests for additional information. Create a calendar to track all important dates related to your claim.

VA Disability Ratings for Sleep Apnea

The VA assigns specific disability ratings for sleep apnea based on symptoms severity and treatment requirements. These ratings directly impact the monthly compensation you can receive as a veteran with this condition.

How the VA Rates Sleep Apnea

The VA rates sleep apnea under the Code of Federal Regulations, specifically 38 CFR § 4.97, Diagnostic Code 6847. Ratings are assigned based on how the condition affects your daily functioning and what treatments you require.

Sleep apnea has been a VA-rated disability since 1996. The VA typically evaluates your condition through medical evidence, including sleep study results that confirm your diagnosis.

Your rating depends on whether you were prescribed a CPAP or other device to help you breath at night, and whether you have symptoms like persistent sleepiness due to the impact on your sleep.  The VA may also consider secondary conditions when determining your overall disability rating.

Be aware that the VA may propose changes to sleep apnea ratings. Major changes could be coming by the end of 2025, potentially eliminating certain rating levels. These changes may arrive as soon as August, 2025.

Criteria for Disability Ratings

The VA uses specific criteria to determine your sleep apnea disability rating:

0% Rating: You have a documented sleep disorder but remain asymptomatic (showing no symptoms) during waking hours.

30% Rating: You experience persistent daytime sleepiness (hypersomnolence) that impacts your daily functioning.

50% Rating: You require a CPAP machine or similar breathing assistance device. This is currently the most common rating for veterans with sleep apnea.

100% Rating: You have chronic respiratory failure with carbon dioxide retention, or you require a tracheostomy (surgical breathing hole).

For the 50% rating, you must provide medical documentation proving you’ve been prescribed a CPAP machine. However, proposed changes may remove the “automatic” 50% rating for CPAP users in the future.

Understanding VA Rating Percentages

Your VA rating percentage directly affects your monthly compensation. For 2025, a veteran with a 30% sleep apnea rating would receive $537.42 monthly in disability benefits (for a single veteran with no dependents, if this is their only rating).

The VA combines ratings when you have multiple service-connected conditions. For example, if you have sleep apnea rated at 30% and another condition like migraines secondary to sleep apnea at 30%, the VA uses a combined rating formula rather than simply adding them together.

You can increase your overall rating by claiming conditions secondary to sleep apnea such as heart conditions, mental health issues, or other related problems that developed due to your sleep disorder.

Treatment Options for Sleep Apnea in Veterans

Veterans dealing with sleep apnea have several effective treatment options available through the VA healthcare system. These treatments aim to improve sleep quality, reduce symptoms, and enhance overall health.

Positive Airway Pressure Therapy

PAP therapy is the first-line treatment for veterans with sleep apnea, especially for those with severe cases. The VA/DoD Clinical Practice Guidelines specifically recommend prescribing PAP as the primary therapy for patients with severe obstructive sleep apnea (OSA).

CPAP (Continuous Positive Airway Pressure) machines deliver a steady stream of air pressure to keep your airways open during sleep. The VA provides CPAP machines to eligible veterans and offers support for proper use and maintenance.

Many veterans notice immediate improvements in sleep quality, daytime alertness, and energy levels once they adjust to CPAP therapy. Regular use is important – wearing your CPAP mask for at least 4 hours per night on 70% of nights is typically considered compliant therapy.

Other PAP options include BiPAP (Bi-level Positive Airway Pressure) and APAP (Automatic Positive Airway Pressure), which may be prescribed based on your specific needs.

Oral Appliance Therapy

Oral appliances are custom-fitted devices that can help treat mild to moderate sleep apnea. These devices work by repositioning your jaw and tongue to keep your airway open during sleep.

The VA offers oral appliance therapy as an alternative for veterans who:

• Cannot tolerate CPAP therapy
• Have mild to moderate sleep apnea
• Prefer a less intrusive treatment option

These appliances are made by dental professionals and adjusted to fit your specific needs. They’re portable, quiet, and don’t require electricity, making them convenient for travel or deployment.

Many veterans find oral appliances more comfortable and easier to use than CPAP machines. However, they may take time to adjust to and regular dental check-ups are needed to ensure proper fit and effectiveness.

New treatments and devices are emerging every year – make sure you talk to your doctor to discuss your options and to keep up with innovations.

Lifestyle Modifications and Behavioral Approaches

Improving your sleep hygiene can significantly help manage sleep apnea symptoms. The VA recommends several lifestyle changes that can complement medical treatments.

Weight management is particularly important, as excess weight can worsen sleep apnea. Even a 10% reduction in body weight can reduce apnea severity by 30-50%.

Sleep position training can help. Sleeping on your side rather than your back may reduce apnea episodes for some veterans.

Avoiding alcohol and sedatives before bedtime can make a big difference, as these substances relax throat muscles and worsen apnea.

Establishing regular sleep patterns helps too. Try to:

• Go to bed and wake up at the same time daily
• Create a cool, dark, quiet sleeping environment
• Avoid screen time before bed
• Limit caffeine after noon

Some veterans benefit from supplements like melatonin to regulate sleep cycles, but always consult with your VA healthcare provider before starting any supplement.

Advanced and Alternative Sleep Apnea Treatments

When standard treatments like CPAP aren’t effective, veterans have access to several advanced options through the VA healthcare system. These alternatives can address both obstructive and central sleep apnea with surgical interventions or specialized therapies.

Tracheostomy and Surgical Solutions

A tracheostomy creates a new airway through your neck directly into your windpipe, bypassing the upper airway blockage. This procedure is typically reserved for severe cases where you experience chronic respiratory failure or dangerous carbon dioxide retention.

For less severe cases, the VA now offers Inspire therapy, an FDA-approved implantable device that stimulates your airway muscles to stay open during sleep. This option works well if you can’t tolerate CPAP therapy.

Jaw advancement surgery might be recommended if your sleep apnea relates to facial structure. These procedures improve sleep quality by repositioning your jaw to prevent airway collapse.

Some veterans benefit from palate procedures that reduce tissue vibration, helping with both snoring and mild to moderate apnea symptoms.

Managing Central Sleep Apnea

Central Sleep Apnea (CSA) differs from obstructive sleep apnea as it involves your brain failing to signal your breathing muscles properly. If you have CSA, your treatment focuses on managing the underlying cause.

Adaptive servo-ventilation (ASV) devices monitor your breathing pattern and provide adjusted air pressure to normalize breathing. This is particularly helpful if you have CSA with heart failure or cor pulmonale.

Medication therapy targets specific causes of your central apnea. For example, if you have CSA due to opioid use, your doctor might adjust your pain management approach.

Supplemental oxygen therapy helps if your CSA relates to altitude or certain medical conditions. You can use this treatment alongside other therapies to maintain proper oxygen levels throughout the night.

The Relationship Between Sleep Apnea and Other Health Conditions

Sleep apnea can significantly impact your overall health by contributing to or worsening several medical conditions. Understanding these connections is crucial for veterans seeking proper VA disability ratings and comprehensive treatment.

Cardiovascular and Respiratory Complications

Sleep apnea puts significant strain on your cardiovascular system. When you stop breathing repeatedly during sleep, your oxygen levels drop, triggering your body to release stress hormones that increase blood pressure.

Veterans with sleep apnea have a higher risk of developing hypertension, which can lead to more serious heart problems. The relationship works both ways – existing heart conditions can worsen sleep apnea symptoms, creating a dangerous cycle.

Sleep apnea is also linked to:

• Heart arrhythmias
• Coronary artery disease
• Increased stroke risk
• Heart failure

Respiratory issues like asthma and COPD can complicate sleep apnea. These conditions may make it harder for you to breathe normally during sleep, potentially increasing the severity of your sleep apnea symptoms.

Mental Health Implications

Your sleep quality directly affects your mental health. Veterans with sleep apnea often experience disrupted sleep patterns leading to chronic fatigue and mood disturbances.

There is a strong bidirectional relationship between sleep apnea and mental health conditions:

• PTSD can worsen sleep apnea symptoms
• Sleep apnea can intensify anxiety and depression
• Poor sleep quality exacerbates existing mental health issues

Many veterans experience chronic insomnia alongside sleep apnea, further complicating treatment. The resulting sleep deprivation can impair cognitive function, affecting your memory, concentration, and decision-making abilities.

Treatment for sleep apnea often leads to improved mental health outcomes, highlighting the importance of addressing both conditions simultaneously.

Sleep Apnea and Metabolic Disorders

Sleep apnea significantly impacts your metabolic health. Disrupted sleep patterns interfere with glucose metabolism and hormone regulation, creating a complex relationship with metabolic disorders.

Diabetes and sleep apnea often occur together, with each condition potentially worsening the other. The oxygen deprivation from sleep apnea can affect insulin sensitivity, while diabetes-related neuropathy may impact breathing control during sleep.

Other metabolic conditions linked to sleep apnea include:

• Obesity (both a risk factor and consequence)
• Metabolic syndrome
• Liver dysfunction
• Hormonal imbalances

Many veterans also experience gastroesophageal reflux disease (GERD) alongside sleep apnea. This connection is bidirectional – GERD can worsen sleep apnea, and sleep apnea can exacerbate GERD symptoms by changing airway pressure.

Appealing a Denied Sleep Apnea VA Claim

When the VA denies your sleep apnea claim, you have options to challenge this decision. Understanding why claims get rejected and how to strengthen your appeal can significantly improve your chances of success.

Reasons Claims Are Denied

The VA frequently denies sleep apnea claims for several key reasons. One common issue is lack of medical diagnosis – you must have a formal sleep study confirming your condition.

Many veterans face denial due to insufficient service connection evidence. The VA needs clear documentation linking your sleep apnea to military service or to another service-connected disability.

Claims often fail due to missing medical evidence or incomplete paperwork. The VA requires comprehensive medical records that establish both the diagnosis and its connection to service.

Some denials occur because veterans can’t demonstrate that the condition began during or was worsened by military service. The timing of symptom onset is crucial for your claim’s success.

How to Strengthen Your Appeal

Act quickly on your appeal. You have one year from your denial letter to file an appeal using one of three options under the Appeals Modernization Act (AMA): Higher Level Review, Supplemental Claim, or Board Appeal. These appeal options can be overwhelming, and while any action is typically better than letting the deadline pass, consider consulting an attorney or accredited claims representative to preserve all your appeal rights and maximize your chances of success.

Gather additional medical evidence to support your claim. This might include:

• New sleep studies
• Medical opinions from specialists
• Documentation of CPAP or other treatment
• Statements about how symptoms affect daily life

Consider obtaining a nexus letter from your doctor explicitly connecting your sleep apnea to military service. This letter should explain the medical reasoning behind this connection.

Buddy statements from fellow service members who witnessed your symptoms can provide powerful supporting evidence. These firsthand accounts help establish when your condition began.

Continue following your treatment plan. We often get questions about whether the VA monitors CPAP compliance through internet-connected devices. While we always recommend following your doctor’s guidance, the VA is not monitoring your device usage to change your rating – they focus on your medical diagnosis and prescribed treatment, not daily compliance data.

Work with a qualified representative who understands the VA rating system for sleep apnea. They can help identify and address the specific reasons for your denial while ensuring you choose the right appeal path for your situation.

Resources and Support for Veterans with Sleep Apnea

Veterans struggling with sleep apnea have access to comprehensive VA healthcare services and community support systems. These resources help manage symptoms and improve overall sleep health.

Accessing VA Medical Care

The VA offers specialized sleep services through programs like the Path to Better Sleep, a free online program developed by VA sleep experts. This resource is available to all veterans seeking to improve their sleep health.

To get started, schedule an appointment with your VA primary care provider who can refer you to a sleep specialist. Many VA facilities have dedicated sleep clinics that provide diagnostic testing, CPAP machines, and ongoing treatment monitoring.

The VISN 21 Sleep Clinical Resource Hub is an example of VA’s specialized sleep services. You can connect with providers through phone, fax, or MyHealtheVet Secure Messaging to improve access to care.

For CPAP equipment and supplies, the VA provides these at no cost if your sleep apnea is service-connected. Regular follow-ups help ensure your treatment remains effective.

Veteran Support Groups and Services

Beyond medical care, connecting with other veterans facing similar challenges can be invaluable. The VA hosts sleep disorder support groups at many facilities where you can share experiences and strategies.

Organizations like Veterans Help Group offer guidance on navigating VA sleep apnea claims. They provide information about the claims process and assistance with appeals if needed.

These free resources are great for getting started. If you run into a roadblock or you get denied, our team at ProVet Legal can help you. Please reach out to us for a free case review.

Veterans struggling with their claims should know that sleep apnea is one of the most common conditions veterans receive disability benefits for, with more than 500,000 veterans receiving these benefits in 2022.

Online forums such as Veterans Benefits Network and Reddit’s r/Veterans feature dedicated discussions about sleep apnea management and VA benefits. These communities offer peer support and practical advice.

For assistance with disability claims, Veterans Service Organizations (VSOs) like the American Legion, VFW, and DAV provide free representation. 

We Are Here To Help You

Sleep apnea affects hundreds of thousands of veterans, yet many struggle to secure the disability benefits they’ve earned through their service. Whether you’re filing an initial claim, appealing a denial, or fighting for a higher rating, the path to VA benefits shouldn’t be one you walk alone. At ProVet Legal, we understand the complexities of sleep apnea claims – from establishing service connection to gathering the right medical evidence to navigating the appeals process.

You served our country and sacrificed your sleep – now let us help you get the benefits you deserve. Contact ProVet Legal today for a free case review. We’ll evaluate your situation, identify the strongest path forward, and fight alongside you to secure the compensation that reflects the true impact of your service-connected sleep apnea.