Central Sleep Apnea

[cooter]

My Dr has me on morphine and percs for my pain. Now my sleep study I just had shows sever Central apnea, and he says, more than likely it's due to the opiates I'm on.

My question is, if I filed a claim for the apnea, will they deny me cause its the meds that causing it or will they just try to get me off of the meds so I wouldn't have apnea?

Coot

[WorkAHolic]

Following this discussion. I was diagnosed last week with severe apnea ( I dont' know if it's obstructive or mixed) I take hydrocodone, meloxicam, gabapentin for a back injury, and zoloft for depression. I found in my medical records where I was prescribed elavil in 2002 by my (then) army PCP before I discharged for sleep problems as well, but I never claimed it, then.

Sorry for the late reply, but I just recently celebrated a birthday and as the nickname says, I am a "workaholic." Sleep apnea is a horse of another color. I can tell you what I've seen at my regional office relating to the subject, but the majority of the time, you are going to need a medical opinion to link it to your military service (if there is no record of sleep problems or a diagnosis in service). You can try and link it secondary to taking medicine prescribed for a service connected condition (for example, I have seen tinnitus secondary service connected for hydrocodone usage for a service connected back condition. There have been studies that link hydrocodone(due to side affects) and tinnitus); however, even with all this being true, it ultimately comes down to the VA examiner you have and if in his/her opinion that condition is caused by medicine usage for a service connected condition. And, of course, it all depends on the luck of the draw with who you get as your VA Examiner, as you may already know. With that being said, let me check with a friend of mine at the VA Regional Office near me and I will get back with you. I will tell you that VA has proposed (but not fully implemented) where you will be able to go to your private doctor with a VA Exam worksheet and have him/her give you the medical opinion. Although this seems like a good idea, unfortunately, if you live in my state, you have to "doctor hop" to find a doctor who would even perform the exam because most doctors here wouldn't want to get involved because of possible legal issues. Let's not even mention the medical insurance part of it. Check back with me soon.

[brokensoldier244th]

Thanks, Workaholic.

The Elavil was for sleeping 'issues' that I was having, though, I can't say that wasn't due to stress/pain/whatever from dealing with my back and waiting for my MEB/PEB. Honestly, the longer I was on profile the more weight I gained, and that has continued ever since. My wife says the sleep issues and breathing have been there since she met me in college, pre-enlistment, but how to show that it was aggravated by later events might be quite a hurdle, since there is no diagnosis of sleep issues pre service, or even in service, other than the elavil-and that was the on post clinic, written on a sick call slip 'take elavil, 10mg'. NO mention on the slip for 'what'.

I honestly wouldn't mind being a precedent setter for chronic pain/medication induce obesity leading to SA, since the less I eat, the less I lose weight. *shrug* I can't shake more than about 10 lbs at a time and if im really careful I don't gain more than 5-10 lbs, either, but that is more tied to diet than activity, and monitoring calories to be under 2000 daily.

Sorry for the late reply, but I just recently celebrated a birthday and as the nickname says, I am a "workaholic." Sleep apnea is a horse of another color. I can tell you what I've seen at my regional office relating to the subject, but the majority of the time, you are going to need a medical opinion to link it to your military service (if there is no record of sleep problems or a diagnosis in service). You can try and link it secondary to taking medicine prescribed for a service connected condition (for example, I have seen tinnitus secondary service connected for hydrocodone usage for a service connected back condition. There have been studies that link hydrocodone(due to side affects) and tinnitus); however, even with all this being true, it ultimately comes down to the VA examiner you have and if in his/her opinion that condition is caused by medicine usage for a service connected condition. And, of course, it all depends on the luck of the draw with who you get as your VA Examiner, as you may already know. With that being said, let me check with a friend of mine at the VA Regional Office near me and I will get back with you. I will tell you that VA has proposed (but not fully implemented) where you will be able to go to your private doctor with a VA Exam worksheet and have him/her give you the medical opinion. Although this seems like a good idea, unfortunately, if you live in my state, you have to "doctor hop" to find a doctor who would even perform the exam because most doctors here wouldn't want to get involved because of possible legal issues. Let's not even mention the medical insurance part of it. Check back with me soon.

[cooter]

Had my 2nd night at the sleep center that ended this morning, and was fitted with a V-PAP that I'll be using. Waiting now for the Insurance Co. to approve it. My earlier appt. with the sleep Dr. said my apnea was sever and complex, mainly central apnea. He also mentioned it was more than likely due to the morphine and percs I'm taking. For VA purposes, studies has proven that opiates are the main causes of Central Apnea, and the others are caused by neck to cranial injuries, spinal surgeries, and some heart conditions. Since I don't have any of the others, my claim will be based from the opiates taken for my SC knee, which is rated 60%.

I'm trying to figure the best route for filing. I have 2 possibles to consider.

1) Should I file now due to the hydrocodone the VA prescribed to me (for knee) until I started seeing an outside Pain Management Dr who changed the script to oxycodone due to the amount of pain...or

2) Should I wait till I'm SC for my back which the same Dr has me on morphine for. So actually, I'm taking morphine with the oxy as a kicker for both injuries. The back issue will be filed as Secondary to the abnormal gait caused from the SC knee.

Since I'm assuming most of us here would prefer I go with #2, I'm wondering if anyone would differ with me, and, with your reasoning of course.

Coot

[71M10]

Had my 2nd night at the sleep center that ended this morning, and was fitted with a V-PAP that I'll be using. Waiting now for the Insurance Co. to approve it. My earlier appt. with the sleep Dr. said my apnea was sever and complex, mainly central apnea. He also mentioned it was more than likely due to the morphine and percs I'm taking. For VA purposes, studies has proven that opiates are the main causes of Central Apnea, and the others are caused by neck to cranial injuries, spinal surgeries, and some heart conditions. Since I don't have any of the others, my claim will be based from the opiates taken for my SC knee, which is rated 60%.

I'm trying to figure the best route for filing. I have 2 possibles to consider.

1) Should I file now due to the hydrocodone the VA prescribed to me (for knee) until I started seeing an outside Pain Management Dr who changed the script to oxycodone due to the amount of pain...or

2) Should I wait till I'm SC for my back which the same Dr has me on morphine for. So actually, I'm taking morphine with the oxy as a kicker for both injuries. The back issue will be filed as Secondary to the abnormal gait caused from the SC knee.

Since I'm assuming most of us here would prefer I go with #2, I'm wondering if anyone would differ with me, and, with your reasoning of course.

Coot

I would get the back connected first, then file. Were you diagnosed with Apnea prior to the medication for the back? If not, they will most likely say that it is the meds for the back that are the primary cause, since you didn't have apnea when it was only your knee.

By waiting you lose effective date though.

However, If the back is SC before the Apnea decision (if its no) is more than a year old you could appeal and keep the earlier effective date.

It is hard to get VA to Multi-task though and they could really make a mess of it.

Best regards,

[john999]

I am going for sleep study in December. I wake up about five times a night and wife says I snore (she does too). I do know that clonazepam and valium will make apnea worse. If you want to gain weight take elavil. Opiates and all these anti-depressants cause people to gain weight. You are being sedated. The drugs like neurontin also cause weight gain.

[cooter]

I think we're on the same page as far as going with the back issue first. That itself, could take awhile to get SC.

I went thru another sleep study when I was only on the oxycodone and it resulted as "boarder line" for wearing the mask, so the morphine, 200mg a day, brought it up from "boarder line" to "sever complex Central Apnea".

Right now I'm waiting for a TDIU claim that's been in adjudication since June 2010, so hopefully it'll be sooner than later when I hear something....Thanks for the reply!

Coot

I would get the back connected first, then file. Were you diagnosed with Apnea prior to the medication for the back? If not, they will most likely say that it is the meds for the back that are the primary cause, since you didn't have apnea when it was only your knee.

By waiting you lose effective date though.

However, If the back is SC before the Apnea decision (if its no) is more than a year old you could appeal and keep the earlier effective date.

It is hard to get VA to Multi-task though and they could really make a mess of it.

Best regards,