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April 13, 2024

How to Service Connect Sleep Apnea Secondary to Sinusitis

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Current medical research indicates strong connections and aggravating factors for sleep apnea secondary to sinusitis, rhinitis, deviated septum, and weight gain or obesity.  

Thus, sleep apnea secondary to sinusitis is one of the most likely secondary VA claims you can file to get service connected VA disability benefits.

In this article, we’ll explore the connection between sinusitis and sleep apnea, evidence requirements for secondary service connection, the rating criteria for sleep apnea secondary to sinusitis, and an example nexus letter between the two conditions (available for download at the end).

Okay, let’s dive in!

Summary of Key Points

  • Sleep apnea has VA ratings from 0 percent to 100 percent, with breaks at 30 percent and 50 percent. The most common VA rating for sleep apnea is 50 percent.
  • It’s important to consider obtaining a nexus letter for a secondary condition if you’re trying to service connect sleep apnea and sinusitis (example letter at the end of this article).

The Connection Between Sinusitis and Sleep Apnea

Sinusitis and sleep apnea are both common conditions that can significantly affect a veteran’s sleep quality and overall health.

Here’s a list of factors explaining why sinusitis can contribute to sleep apnea:

  • Nasal Congestion: Sinusitis often causes nasal congestion due to inflamed nasal passages and sinus blockages. This congestion can obstruct airflow during sleep, leading to breathing difficulties and apnea episodes.
  • Obstruction of Airways: Inflamed sinuses can lead to swelling and blockages in the nasal passages, which can obstruct the free flow of air into the lungs during sleep, resulting in apnea episodes.
  • Increased Mucus Production: Sinusitis triggers the production of excess mucus, which can further block the airways, especially during sleep when the body’s natural defenses and clearance mechanisms are reduced.
  • Nasal Polyps: Chronic sinusitis can lead to the formation of nasal polyps, which are noncancerous growths in the nasal passages. These polyps can physically obstruct airflow, contributing to sleep apnea.
  • Disrupted Sleep Patterns: Sinusitis often causes discomfort and pain, leading to disrupted sleep patterns. Fragmented sleep can exacerbate sleep apnea or contribute to the development of obstructive sleep apnea (OSA) due to increased relaxation of the throat muscles during sleep.
  • Inflammation: The inflammation associated with sinusitis can extend to the throat and airway tissues, leading to further narrowing of the air passages and increased susceptibility to apnea episodes.
  • Underlying Conditions: Sinusitis may be associated with underlying conditions such as allergies or respiratory infections, which can aggravate sleep apnea or predispose individuals to develop it.
  • Chronicity: Chronic sinusitis, especially when left untreated, can perpetuate ongoing inflammation and obstruction of the nasal passages and airways, maintaining a cycle of sleep-disordered breathing including sleep apnea.
  • Reduced Oxygen Saturation: Persistent nasal congestion and obstructed breathing during sleep can result in decreased oxygen levels in the bloodstream, which may exacerbate the severity of sleep apnea and contribute to its complications.
  • Quality of Life Impact: Chronic sinusitis can significantly impact quality of life, leading to fatigue, daytime sleepiness, and reduced cognitive function, all of which are common symptoms associated with sleep apnea.

    Evidence Requirements for Secondary Service Connection

    Here’s a list of questions the C&P examiner will review along with evidence requirements to get VA benefits for VA sleep apnea secondary to sinusitis:

    • Does the veteran have a diagnosis of sleep apnea confirmed by a sleep study? If yes, indicate the type of sleep apnea, date of diagnosis, and sleep study results.
    • Does the veteran have service-connected sinusitis? If yes, indicate the date of diagnosis and date of service connection.
    • Does the veteran have symptoms of sleep apnea? If yes, indicate the severity in terms of frequency, severity, and duration, along with the current treatment plan to include the need for a breathing device such as a CPAP.

    VA Disability Rating for Sleep Apnea Secondary to Sinusitis

    The VA rates obstructive, central, and mixed sleep apnea secondary to sinusitis from 0% to 100% with breaks at 30% and 50%.

    Here’s the VA disability rating criteria for sleep apnea according to 38 CFR, Part 4, the Schedule for Rating Disabilities, Diagnostic Code (DC) 6847, Sleep Apnea Syndromes:

    • A 0% rating is assigned when sleep apnea is diagnosed but does not require the use of a CPAP machine or other breathing assistance devices, and it does not significantly affect daily functioning. This means that there is no associated disability compensation. The 0% rating is non-compensable, meaning a veteran is not eligible to receive compensation.
    • A 30% rating is typically assigned if sleep apnea requires the use of a CPAP (Continuous Positive Airway Pressure) machine or a similar device for treatment. This rating indicates moderate to severe sleep apnea.
    • A 50% rating is assigned when sleep apnea is moderate to severe, persistent, and results in chronic daytime sleepiness and significant impairment of cognitive and social functioning. You require the use of a breathing device such as a CPAP machine.
    • A 100% rating may be assigned if sleep apnea is so severe that it necessitates the use of a CPAP machine or other assisted ventilation devices, and it significantly impacts the individual’s overall health and ability to function. This rating indicates total disability.

    Example Nexus Letter for Sleep Apnea Secondary to Sinusitis [Download]

    Click the link below to download an example nexus letter for sleep apnea secondary to service connected sinusitis.

    Note: This letter is an example only and must be tailored to the facts and circumstances of your case.

    About the Author

    Brian Reese
    Brian Reese

    Brian Reese

    Brian Reese is one of the top VA disability benefits experts in the world and bestselling author of You Deserve It: The Definitive Guide to Getting the Veteran Benefits You’ve Earned (Second Edition).

    Brian’s frustration with the VA claim process led him to create VA Claims Insider, which provides disabled veterans with tips, strategies, and lessons learned to win their VA disability compensation claim, faster, even if they’ve already filed, been denied, gave up, or don’t know where to start. 

    As the founder of VA Claims Insider and CEO of Military Disability Made Easy, he has helped serve more than 10 million military members and veterans since 2013 through free online educational resources.

    He is a former active duty Air Force officer with extensive experience leading hundreds of individuals and multi-functional teams in challenging international environments, including a combat tour to Afghanistan in 2011 supporting Operation ENDURING FREEDOM.

    Brian is a Distinguished Graduate of Management from the United States Air Force Academy, Colorado Springs, CO, and he holds an MBA from Oklahoma State University’s Spears School of Business, Stillwater, OK, where he was a National Honor Scholar (Top 1% of Graduate School class).

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