Sleep apnea is a debilitating sleep-associated breathing condition. Veterans who suffer from sleep apnea develop chronic health problems that can worsen over time. Patients find it hard to hold down a job, and ongoing treatment for sleep apnea can average over $3,000 per year. Without treatment, the condition can become life threatening.
Securing VA benefits for sleep apnea treatment is therefore crucial. But winning sleep apnea VA benefits can be challenging. This quick and clear guide to winning sleep apnea VA claims secondary to post-traumatic stress disorder (PTSD) can help you prepare a compelling claim, fight any denied claims, and collect the benefits you deserve.
Sleep Apnea is Common in Veterans
Military veterans are particularly susceptible to developing sleep apnea due to its close association with PTSD. Veterans are three times as likely to get a PTSD diagnosis than civilians. Studies have shown that over half (52%) of veterans test positive for sleep apnea.
In the civilian population, the risk for sleep apnea increases with age. But age doesn’t play a significant role among veterans. Nearly 70% of Vietnam veterans with PTSD also have sleep apnea and, in one study, 69% of young Iraq and Afghanistan veterans tested positive for sleep apnea.
Veterans with combat experience, mental health disorders, cancer, or cardiovascular disease also experience higher rates of sleep disorders. PTSD patients who test positive for sleep apnea show greater risk for substance abuse, depression, suicide, and early death.
3 Types of Sleep Apnea
There are three general kinds of sleep apnea diagnoses: obstructive sleep apnea (OSA), central sleep apnea, and complex sleep apnea.
- Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is the most common, affecting 50% of women and 37% of men. Around 84% of sleep apnea patients have OSA. OSA involves a physical obstruction of the airway. The tongue, soft palate, and uvula relax during sleep and collapse over the throat, blocking air flow. Symptoms may include lethargy during waking hours, insomnia, snoring, dry mouth, confusion, and frequent headaches.
- Central Sleep Apnea
Central sleep apnea is a neurological condition. This is the rarest type of sleep apnea, affecting around 0.4% of sleep apnea patients. There is no physical airway obstruction as with OSA. Instead, the nervous system fails to send breathing signals to the body during sleep, often due to drug use, congestive heart failure, high altitude, or an underlying condition. Symptoms may be undetectable; however, some central sleep apnea patients experience insomnia, fatigue, or difficulty concentrating.
- Complex Sleep Apnea
Complex Sleep Apnea is a syndrome characterized by a combination of both OSA and central sleep apnea. Around 15% of sleep apnea patients are diagnosed with this type. The existence of both types of sleep apnea can be difficult to diagnose. In many cases, OSA is diagnosed first. Complex sleep apnea may then be detected when the patient shows no improvement with common OSA treatments. Symptoms resemble those of OSA, including lethargy during waking hours, insomnia, snoring, dry mouth, confusion, and frequent headaches.
Weight gain, obesity, age, alcohol abuse, sedative use, and preexisting conditions like type II diabetes, hypertension, acid reflux disease, and cardiovascular disease can contribute to sleep apnea and worsen the condition.
Dangers Of Sleep Apnea
Actress Carrie Fisher of the Star Wars franchise reportedly lost her life to “sleep apnea and other causes” in December 2016 after a heart attack during an overseas flight. Famed Bollywood singer Bappi Lahiri had been suffering from obstructive sleep apnea when he lost his life in February 2022.
Failure to breath is obviously a dangerous situation. But untreated sleep apnea has not been shown to directly cause suffocation or death. With OSA, the body reflexively turns or moves once oxygen levels become low enough, releasing the airway obstruction. With central sleep apnea, a similar reflex kicks in, waking the person at low oxygen levels and thereby triggering breathing.
However, sleep apnea does indirectly decrease life span by increasing the risk of life-threatening health conditions. Thousands of deaths are attributed to untreated sleep apnea each year. Months of sleep deprivation and oxygen deprivation take a toll on the body’s vital organs.
Common causes of death from sleep apnea include abnormal heart rhythms, high blood pressure, pulmonary hypertension, heart attack, diabetes, and stroke. Around 42% of sleep apnea patients die from stroke or cardiovascular disease compared to the 26% of people who do not have sleep apnea. Without treatment, the risk for death nearly doubles.
Most Successful Treatments for Sleep Apnea
While there is no way to permanently fix sleep apnea, a wide variety of treatments are available to lessen the symptoms and health impacts, from breathing devices, to surgery, to lifestyle changes.
The most effective sleep apnea treatment is the continuous positive airway pressure (CPAP) machine. A CPAP machine is essentially an air pump. Before sleep, the patient places a mask over the nose and/or mouth. During sleep, pressurized air flows continuously through the mask, keeping the airway open and preventing obstruction.
Alternative breathing devices include:
- Expiratory positive airway pressure (EPAP) device: a nasal device using valves to generate air pressure during exhalation.
- Auto-adjusting positive airway pressure (APAP) machine: also known as auto-CPAP, automatically adjusts air flow based on breathing patterns.
- Bilevel positive airway pressure (BPAP / BiPAP) machine: adjustable pressure for improved comfort.
You can also treat sleep apnea without a CPAP. Oral appliances are another form of non-surgical sleep apnea treatment. These devices are custom-fit to your mouth to be worn during sleep. Oral sleep apnea devices function to hold the tongue away from the soft palate and airway. For example, tongue retaining devices hold the tongue forward during sleep to prevent blockage of the upper airway.There are also mandibular repositioning mouthpieces that fit over the teeth and hold the jaw open to prevent airway obstruction.
For mild obstructive sleep apnea, patients can try the eXciteOSA device, a mouthpiece worn during the day that stimulates the tongue with electrodes to improve muscle function and lower the risk of airway obstruction during sleep.
Medications are available to treat side effects of sleep apnea. For example, the drug modafinil is approved to treat daytime lethargy in CPAP users. However, no medications are currently available to treat sleep apnea itself.
Surgery has proven effective in treating sleep apnea for patients that do not respond well to CPAP treatment. Surgery may be performed to open the airway or to implant an electrical device to help stimulate breathing during sleep.
Surgical treatments may include:
- Adenotonsillectomy: Surgical removal of tonsils and adenoids.
- Hypoglossal nerve implant: surgical insertion of a nerve stimulator, like the Inspire implant, that acts to keep the tongue from blocking the airway.
- Uvulopalatopharyngoplasty: Surgical repositioning or removal of the tissue surrounding the upper airway.
- Hyoid suspension: Surgical repositioning of the hyoid bone, like the AIRLIFT hyoid suspension procedure, to improve air flow.
- Maxillomandibular advancement: surgical repositioning of the jaw to open the airway
Veterans may also be able to reduce they symptoms of sleep apnea on their own, by shifting the sleeping position to side or stomach, losing weight, increasing physical activity, quitting smoking, and limiting alcohol use.
How Much Does Sleep Apnea Treatment Cost?
According to the American Academy of Sleep Medicine, patients with sleep apnea are paying thousands of dollars each year for treatments. In order to receive treatment, you have to take a sleep study (polysomnogram) which can cost as much as $5,000 per night.
CPAP machines retail for around $1,000 or more. BiPAP machines can cost over $6,000. And these machines need regular maintenance and replacement parts like filters (~$30 each), tubing (~$50), and masks (~$100).
Not to mention the loss of productivity. Sleep apnea is disabling. Veterans with sleep apnea can find it difficult to maintain employment due to poor concentration, lethargy, insomnia, and accompanying health problems.
Winning VA benefits for sleep apnea is essential.
Does The VA Pay for Sleep Apnea?
Yes. Veterans can connect sleep apnea to military service by proving either direct or secondary service connection. VA benefits for sleep apnea may cover the costs of sleep testing, CPAP machines, oral devices, surgery, and other assistance depending on your VA rating for sleep apnea and the recommendations of your doctor.
As of the publication date of this article, veterans can receive a 100% sleep apnea rating, a 50%, 30%, or 0% rating. The VA ratings for sleep apnea depend on the severity of the sleep apnea as determined by a doctor.