Insomnia & Sleep Apnea

[usocazy]

Hi - I've been retired for over 4 years and diagnosed with sleep apnea prior to leaving the service. I've been on a CPAP ever since and just went through another sleep study (5 years after the original) that confirmed previous findings and increased the pressure setting on my CPAP machine. Currently at 50% service-connected disability for sleep apnea.

My question is around insomnia. I have it and it's in my medical records prior to leaving the service. I've been on Ambien for insomnia for over 10 years. Can insomnia be claimed in conjunction with sleep apnea?

[john999]

If insomnia is related to depression or anxiety then you may have a case.  I have OSA and insomnia.   Every day when I wake up I am surprised.  I would make an appointment with a VA shrink and complain about insomnia.  It is probably not directly related just to OSA.  Do you have PTSD diagnosis or any other mental health DX.  The VA will treat your insomnia as a symptom unless it is organic IMO.

[Vync]

41 minutes ago, usocazy said:

Can insomnia be claimed in conjunction with sleep apnea?

Yes, but expect the VA to initially try saying they are pyramiding.

However, there are a number of other ratings which include sleep issues as part of their evaluation criteria, such as neurological (i.e. TBI) or mental health.

 

Insomnia as a "Chronic sleep impairment" may be related to nightmares, PTSD, depression, anxiety, etc... may related to mental health disability:

Quote

Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events).

30

 

Insomnia resulting in persistent daytime tiredness may be related to a respiratory disability:

Quote

6847   Sleep Apnea Syndromes (Obstructive, Central, Mixed):
Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requires tracheostomy	100
Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine	50
Persistent day-time hypersomnolence	30
Asymptomatic but with documented sleep disorder breathing	0

 

[rhoe]

Both these answers are entirely inaccurate. 

You stated that your insomnia is noted in your in-service medical records (i.e. service treatment records). 

If you have a diagnosed insomnia disorder under the DSM 5, direct service connection will be considered without any regard to your OSA, because the OSA is irrelevant. Chronic sleep impairment without a diagnosis of insomnia disorder can be linked to another psychiatric disorder, but if you are diagnosed with insomnia, this is a separate and distinct condition and will be evaluated separately, likely under DC 9422 at 10-30%, depending on your actual functional impairment as a result.