Claiming Sleep Apnea as a Secondary Condition – What to Know!

Sleep Apnea

VA specialists in San Diego in 2020 suggested that Veterans are four times more likely to develop sleep disorders, especially Sleep Apnea, than non-Veterans.

When diagnosed Sleep Apnea you can receive up to a 100% VA Disability rate, depending on the severity of its symptoms and the effect they may have on your ability to work and function in everyday life. Sleep Apnea can also trigger several physical and mental health conditions, which can be qualified as secondary and increase your VA Disability rate. 

Since every case is based on individual circumstances and the VA math is not a straightforward process, we strongly recommend using our VA Rate Calculator and consulting a professional to find out how these secondary conditions can affect your overall VA disability rate. 

This Blog covers the most common secondary conditions of Sleep Apnea and how to claim them. We will also explain why you might get denied and how to strengthen your claim. 

What is Sleep Apnea and Secondary Conditions

Sleep Apnea is a condition that causes your breathing to stop and restart several times while you’re asleep. This can prevent your body from getting enough oxygen, which in turn may lead to the development of additional health problems.

Lack of healthy sleep on its own can greatly affect the quality of your life, but when it comes to decreased oxygen levels, there are many  severe conditions that can be aggravated or caused by your service-connected Sleep Apnea. 

Here are some of the disabilities that most often qualify as secondary to Sleep Apnea:

1) Post-Traumatic Stress Disorder (PTSD) 

PTSD and Sleep Apnea often go hand in hand since they have common triggers and symptoms, which can worsen each other – This link is called a bidirectional relationship. 

Veterans with PTSD are more likely to claim Sleep Apnea, and vice versa. Common symptoms include:

  • Hyperarousal (Exaggerated startle response, irritability) 
  • Muscle tension specially in the upper body, affecting breathing
  • Sleep disruptions including frequent awakenings that trigger nightmares

2) Gastroesophageal Reflux Disease (GERD) 

GERD is a digestive disorder that occurs when stomach acid flows back up from the stomach into the esophagus. It causes discomfort and severe pain in the chest and abdomen, as well as coughing and difficulty breathing.

There is a strong connection between GERD and Sleep Apnea because it prevents the esophagus from working the way it should while you are asleep. As a result, you may develop GERD or the condition can get aggravated, if it already exists.

In turn, GERD can lead to the development of Sleep Apnea as the concentration of gastric acid in the esophagus causes spasms in the vocal cords leading to sleep disorder.

3) Anxiety 

Anxiety Disorder is a wide term that may include:

  • Social anxiety
  • Panic attacks
  • Certain phobias ( Fear of close spaces, blood, loud noises, etc.)

Unfortunately, Anxiety Disorder is very common among Veterans and active-duty members due to their exposure to unique stressors and traumas associated with military service, deployment, and combat. Though Anxiety Disorder is often seen as a mental disorder, it may have severe effects on your body, including:

  • Muscle tension that may affect breathing
  • Release of stress hormones like cortisol, which disrupt sleep
  • Increased arousal that prevents you from getting a healthy restful sleep

All these effects interfere with sleep and can lead to the development and aggravation of Sleep Apnea. The more severe your anxiety, the worse your Sleep Apnea gets, and vice versa.

4) Asthma 

Asthma is a severe and potentially dangerous respiratory condition that affects your airways, making it hard to breathe. Both Asthma and Sleep Apnea affect the upper and lower respiratory tracts. Therefore, both conditions have overlapping symptoms:

  • Shortness of breath
  • A whistling or wheezing sound when exhaling
  • Chest tightness or pain
  • Trouble sleeping caused by shortness of breath

This affinity makes it easier to establish a link between Asthma and Sleep Apnea and file a claim for secondary disability.

5) Hypothyroidism 

Hypothyroidism, also called underactive thyroid, or hypothyreosis, is a disorder of the endocrine system in which the thyroid gland does not produce enough thyroid hormones. Its common symptoms are:

  • Fatigue
  • Puffy face
  • Constipation
  • Depression
  • Slowed heart rate

Since Hypothyroidism affects the upper airways, it often causes or aggravates Sleep Apnea.

6) Sinusitis 

Sinusitis, or rhinosinusitis, is an inflammation of the mucous membranes that line the sinuses. Symptoms of this condition include: 

  • Thick nasal mucus
  • Plugged nose 
  • Facial pain.

Affecting throat and nose, Sinusitis is also often linked to Sleep Apnea, and you can claim a secondary condition if you are diagnosed with one of them.  

Note that Chronic Sinusitis is also connected to military burn pit exposure, which is a presumptive condition for qualifying Veterans.

7) Tinnitus 

Tinnitus is a ringing, buzzing, or high-pitched noise that you may hear when there is no external sound. It is usually a symptom of a service-connected circulatory system disorder, hearing loss, or a result of ear injury. 

Back in 1993 medical research proved the connection between Tinnitus and sleep disorders including Sleep Apnea. Since Tinnitus is one of the most common VA disability claims, qualifying Veterans are often eligible for secondary service connection for Sleep Apnea. The connection works both ways.

8) Depression 

Depressive disorder, also known as depression, is another condition, that has a proven bidirectional connection with Sleep Apnea. 

Statistically, about 20% of Veterans are diagnosed with depression, and just like this condition often affects sleep patterns, Sleep Apnea in turn may lead to physiological changes that cause a depressed state of mind.

9) Deviated Septum 

The term Deviated Septum means that the bone and cartilage that separate the nose in the middle are crooked, which makes one nasal passage smaller than another.

This condition may lead to:

  • Trouble breathing through the nose
  • Stuffiness
  • Congestion
  • Recurrent sinus infections

All these symptoms often contribute to the development and aggravation of Sleep Apnea. On the other hand, Sleep Apnea causes tissues in the upper airway to collapse and obstruct nasal passages, causing or worsening Deviated Septum.

10) Weight Gain/Obesity 

According to VA Healthcare, 38% of Veterans are considered overweight, and 41% have a BMI in the Obesity range. 

There are several ways weight gain and obesity can provoke or worsen Sleep Apnea:

  • Decreased muscle tone, especially in the upper airway leads to obstruction of breathing
  • Hormonal changes caused by weight gain affect the regulation of breathing
  • Increased inflammation associated with obesity narrows the airway

In turn, Veterans with Sleep Apnea are more prone to weight gain than those who have the same BMI and health status but do not suffer from the sleep disorder. It is often associated with overeating, decreased physical activity, and metabolism changes caused by Sleep Apnea.

Filing for Secondary Sleep Apnea – What Makes a Successful Claim

Filing a claim for a secondary service connection for Sleep Apnea is the same procedure for any other disability. You will use the same form as for the primary service connection (VA Form 21-526EZ).

Also, you will need to provide:

  • Strong evidence of service connection for the primary disability
  • Diagnosis for a secondary condition
  • Nexus statement that establishes the link between the primary and secondary condition

It is very important to collect and provide all the necessary evidence on time and in perfect order. Otherwise, the process may take much longer than you expect. You can even be denied, even though the connection between your PTSD or Asthma and Sleep Apnea may seem obvious.

Here are the main reasons for denial when you claim a secondary disability:

  1. Lack of Medical Evidence
    Whether you are suffering from mental or physical symptoms of the condition, it is crucial to provide your thorough medical history with diagnosis, treatment, and medication records.
  2. Insufficient Nexus 
    A strong nexus, or a direct link, between the primary and secondary conditions is crucial. The Nexus statement should demonstrate how the secondary condition is caused or aggravated by the primary condition. For example, how Sleep Apnea leads to disruption of the esophagus’ work and the development of GERD.
  3. Inadequate Documentation
    If your medical documentation is incomplete, outdated, or inconsistent your case is likely to be delayed or even denied.

This is not an exhaustive list of reasons why your claim for secondary conditions for Sleep Apnea can be denied. Bureaucratic obstacles, miscommunication, and a lack of relevant information can make your claim process much harder than it should be.

At VCU, we emphasize the importance of educating Veterans and their families about their rights and benefits, helping them make informed decisions about their cases, and providing complete and clear evidence using the wide network of our legal and medical experts. Getting professional assistance will ensure that the claim process covers all your bases. And, even if you are denied, we will assist with your appeal.


Many Veterans suffer from worsening symptoms of their disabilities without even knowing that they can make secondary claims and increase their compensation. The conditions covered here are only some of the  ratable disabilities that can be linked to Sleep Apnea.

Don`t miss your chance to claim what is rightfully yours. Book your FREE 30-minute call with a Veterans Expert today. It will be the first and the most important step towards getting a just compensation for your honorable service.

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