How to Connect Sleep Apnea to Military Service

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Many veterans are diagnosed with sleep apnea after military service, often because symptoms went unnoticed or untreated for years before a sleep study confirmed the condition.

A delayed diagnosis doesn’t mean sleep apnea isn’t related to service. What matters is whether the condition can be medically linked to events, symptoms, or other disabilities connected to your time in uniform.

This post explains how sleep apnea is service-connected, what evidence the VA looks for, and what steps to take if your claim is denied.

Summary of Key Points

Sleep apnea can be service-connected on a direct basis, as a secondary condition, or through aggravation.

To prove direct service connection for sleep apnea, you must have a current diagnosis, evidence of an in-service event, injury, or aggravation, and a medical nexus linking the two.

To prove secondary service connection for sleep apnea, you must have a current diagnosis and a credible medical nexus (link) connecting it to another (already service-connected) condition.

Strong medical evidence, including a DBQ, nexus letter, or buddy statement, often determines whether a claim is approved or denied.

How is Sleep Apnea Service-Connected?

To service connect sleep apnea, the VA looks for a clear link between your military service and your current diagnosis. There are three main ways this can happen: direct service connection, secondary service connection, or service connection via aggravation. Let’s take a closer look at each of these paths.

Direct Service Connection

Sleep apnea can be directly connected to service when symptoms began during service and continued after discharge, even if the condition wasn’t formally diagnosed at the time.

To prove direct service connection, you must have:

A current diagnosis

An in-service event, injury, illness, or aggravation

A medical nexus (i.e., link) between your current diagnosis and your in-service event, injury, or illness

Secondary Service Connection

Sleep apnea may also be service-connected if it developed because of another service-connected condition, such as PTSD, sinus conditions, rhinitis, or weight gain tied to a service-connected disability.

To prove secondary service connection, you must have:

A current diagnosis of your secondary condition

A medical nexus between your secondary condition and primary service-connected condition

Aggravation

If you had been diagnosed with sleep apnea before service, but it worsened due to military duties, deployments, or exposures, the VA may recognize service connection based on aggravation.

Note on Ratings:

Once sleep apnea is service-connected, the VA assigns a disability rating based on the severity of your condition and treatment requirements. You can learn how ratings work and what compensation you may qualify for in our complete guide to sleep apnea VA disability ratings.

>> View the Guide to Sleep Apnea VA Ratings

How to Prove Sleep Apnea is Service-Connected

To be eligible for VA benefits for sleep apnea, you must establish a direct link between your condition and your military service.

This requires building a strong case with multiple forms of evidence that work together to demonstrate when your symptoms began, how they’ve progressed, and why they’re connected to your time in service.

Here’s a look at four ways to support proving service connection.

Medical Evidence

Medical records play a key role in proving sleep apnea is service-connected. This includes sleep studies confirming your current diagnosis, treatment records documenting ongoing symptoms, and provider notes documenting the duration of the condition.

Records that mention symptoms during or shortly after service, such as loud snoring, breathing pauses during sleep, chronic fatigue, or daytime sleepiness, can be especially valuable.

Evidence showing consistent symptoms over time helps establish continuity, even when your current diagnosis comes later.

Buddy Letters

A buddy letter can provide firsthand observations from individuals (i.e., spouse, friends, or fellow service members) who have witnessed your sleep apnea symptoms, filling gaps that medical records may not address.

They show how the condition affects your daily life, work performance, and personal relationships.

Buddy letters can strengthen the case for service-connection by detailing the severity of your condition and its connection to military service.

Learn More: How to Write a VA Buddy Letter for Sleep Apnea

Disability Benefits Questionnaire (DBQ)

A disability benefits questionnaire (DBQ) is a standardized medical form completed by a qualified healthcare provider to assist the VA in evaluating a disability claim.

A sleep apnea DBQ documents key medical facts about your condition, including diagnosis, symptoms, and treatment.

While a DBQ alone doesn’t establish service connection, it strengthens your claim by clearly outlining the severity and medical history of the condition.

>> Full List of VA DBQ Forms

Nexus Letter

A nexus letter for sleep apnea is a written medical opinion from a healthcare provider that explains how your current condition is connected to military service.

It can also show that a condition was caused or worsened by another service-connected disability.

Nexus letters aren’t required; however, they frequently can be the difference between approval and denial.

>> Sample Nexus Letter for VA Disability Claims

VA Denied Sleep Apnea Claim? What to Do Next

Claim denials happen, but they don’t have to be the end of the road. Common reasons for a VA claim denial include:

Lack of a current diagnosis

Inefficient medical evidence

No proof of service connection

A missing or weak nexus opinion

Incomplete forms

If your sleep apnea VA claim was denied, you can:

File a supplemental claim

Ask for a higher-level reviewer to review your claim

Appeal to the Board of Veterans’ Appeals

>> View Our Complete Guide on Filing an Appeal

Conclusion

To connect sleep apnea to military service, you’ll need a current diagnosis, evidence of something that happened during service, and a medical link tying the two together. Sleep apnea can be service-connected directly, as a secondary condition, or through aggravation.

When your sleep apnea claim is backed by strong medical evidence, including DBQs and nexus letters, you put yourself in a much better position for approval.

After service connection is established, your VA rating determines your compensation level. You can learn more in our complete guide to VA Ratings for Sleep Apnea.

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FAQs | Frequently Asked Questions

How is sleep apnea tied to military service?

Sleep apnea may be tied to service through in-service symptoms, environmental exposures, or as a secondary condition linked to another service-connected disability.

How hard is it to get sleep apnea service-connected?

Sleep apnea claims can be challenging, but many claims succeed with strong medical evidence and a well-written nexus letter from a licensed medical provider.

Can sleep apnea be service-connected years after discharge?

Yes. A delayed formal diagnosis doesn’t prevent service connection if evidence shows symptoms began during service, or the condition is linked to a service-connected disability.

Do I need a nexus letter for sleep apnea?

A nexus letter isn’t required, but it often plays a key role in establishing service connection, especially when the VA questions the link to service.

Why does the VA deny so many sleep apnea claims?

Common reasons include missing nexus opinions, lack of current diagnosis or service connection, and incomplete paperwork.

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The Quality Assurance (QA) team at VA Claims Insider has extensive experience researching, fact-checking, and ensuring accuracy in all produced content. The QA team consists of individuals with specialized knowledge in the VA disability claims adjudication processes, laws and regulations, and they understand the needs of our target audience. Any changes or suggestions the QA team makes are thoroughly reviewed and incorporated into the content by our writers and creators.

About the Author

Kelly Olone

Kelly Olone is a military spouse who earned her degree in Psychology from Florida International University. After working in the non-profit sector for several years, she turned to her passion for writing. She aims to contribute to a better understanding of the valuable benefits that veterans deserve. As a mom, Kelly navigates the delicate balance between deadlines and bedtime stories with finesse.

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