Do you need to be diagnosed in service for sleep apnea?

[mouse12555]

I have been diagnosed with sleep apnea during an overnight VA facility test, and have an APAP machine . My psychologist who monitors my PTSD, ( 50 % disability) suggested I take the test . I have been told you need to have been diagnosed with sleep issues  during my period of service . I am a Vietnam vet . To my knowledge there was no such thing back in 1967 thru 1970 period where I spent  3 consecutive years as a medic in the Far East theater. I didn't even have one medical exam during that time for anything . Just self treatment. 

My question: is is true you need to have been diagnosed while in the military?

 

 

[Buck52]

yes you do need a Dx for sleep apnea

you need 3 things

A CURRENT DIAGNOSIS.

A current diagnosis means you currently have the condition for which you are seeking benefits.   the current diagnosis is present.

VA diagnosed the veteran with sleep apnea and prescribe a CPAP.  So ,the veteran should have satisfied that element of proof.

But, the current diagnosis is not the only part that you have to prove to VA.  You also have to prove two additional elements.

AN INCURRENCE OR AGGRAVATION OF SLEEP APNEA DURING YOUR ACTIVE DUTY MILITARY SERVICE

Your sleep apnea either had to start or worsen during your military service.  This is part of the idea of service connection.  It is a connection between your service and the condition for which you are claiming compensation.

The incurrence or aggravation is like the starting point on a line.  Your current diagnosis is the ending point.  Then, you need to have a line connecting those two points which is the third thing you must prove to VA:

A NEXUS BETWEEN YOUR CURRENT DIAGNOSIS AND YOUR IN SERVICE EVENT

The nexus is the link that connects your in service event to your current diagnosis.  This is what creates the service connection between what happened to you in service and the condition/disability which you currently have.

Usually, nexus is going to be in the form of medical evidence.  Often, it could be an opinion from a doctor who has treated you for the condition.

 

[broncovet]

I agree with Buck.  

However, NO, you dont need to be diagnosed "in service", but you must have a CURRENT diagnosis.  There is a difference.  

As Buck stated you need the Caluza elements of 1) Current diagnosis 2) In service EVENT or aggravation

and 3) nexus or doc who states your current diagnosis of sleep apnea is "at least as likely as not" due to 

xx event in military service.  

An "event" in military service which could cause sleep apnea could be something like a face injury, or something that could cause sleep apnea.  

Some Vets have been awarded sleep apnea "secondary" another service connected condition.  For example, there is some evidence linking sleep apnea and PTSD.  

https://www.psychiatryadvisor.com/ptsd-trauma-and-stressor-related/ptsd-severity-sleep-apnea-veterans/article/417489/

This does not mean just because you are sc for PTSD, that you will get sleep apnea secondary to PTSD.  THAT would require a doctor who said "YOUR" PTSD caused "YOUR" sleep apnea.  

[Gastone]

Mouse, what type of SA have you been DX with, OSA, Central CSA or a combination MSA?

If it's OSA, how do you stack up in regards to BMI 28+%, Neck 17++IN, Large Tongue? Your age, long history of snoring, BMI %, large Stomach, and Neck along with a large Tongue are the major causes of Sleep Breathing problems.

Without, in-service medical documentation supporting a Direct SA SC Claim,  you'll probably end up filing an SA Secondary to your 50% PTSD. What's the date of your PTSD Award and the date of the SA DX? You're a Nam Vet, so chance are if your BMI is north of 28%, you didn't just pork up last week. A long history of excess weight will way heavily (no Pun) against the PTSD as the causative Nexus condition.

An OSA claims Secondary to PTSD is a very difficult sell.

[broncovet]

I agree with Gastone.  Its exceptionally difficult for a Vietnam Era Vet to get SC for sleep apnea, since there was no such diagnosis in the 70's.  

However, we can learn from Alex Graham, here.  You see, there was also no test for Hep c, back in the 70's, but Alex has managed to figure that one out.  In other words, just because medical science was lacking in the 70's, is not a good reason, and does not prove that the malady was not caused by service.  That is, the military can cause hep c (or sleep apnea) and it takes many many years for these disorders to manifest themselves as life threatening.  The lack of a test for hep c in the 70's or a lack of a sleep apnea test, does not mean that the service did not cause the disorders.  The disorder can be present, but  un diagnosed, for decades sometimes.  

Maybe Alex will chime in..he has great experience with hep c.  And, sleep apnea is similar to hep c in that a failure of VA docs to recognize the disorder in the 70's does not mean that hep c wont kill you in 2018.  

Sleep apnea can be a killer, too.  What happens with untreated sleep apnea is the heart does not get enough oxygen at nite..because you frequently are gasping for breath.  The heart responds by making a portion of the heart bigger.  This "unbalances" the heart and often leads to afib.  As time goes on, the condition worsens and causes CHF and death.  

There was a football player who died of sleep apnea, probably from what I described.  

[Buck52]

Gastone  he could file secondary to his PTSD Meds, Because some meds you take for PTSD will cause the OSA Depending on the sleep Doc to nexus this.

I never had S.A.   As for as I know  but after getting out and  dx for Chronic PTSD years later and started taking the PTSD Medications to Include the sleep Aids.

I started having problems breathing and Snoring loud and would stop breathing, the Meds made my brain so relax & my brain was so relaxed it never signal me to take that next breath(the way the Sleep Dr explained it to me anyway) Anyway MH Dept order me a sleep study and I was diagnosed with Mild to Severe Sleep Apnea and was given a C-PAP Machine to use  which it helps me sleep better.

As to which I never filed a Sleep Apnea claim for this, but just saying if this Veteran is having the same problem  that may be the route to take with a VA Sleep Apnea Claim?

[broncovet]

UNLESS you have a VA doc who will provide a nexus, then you will need an IMO/IME to get service connected for sleep apnea

I went to visit with my wifes sleep doc.  I asked him specifically, "Does PTSD or depression cause sleep apnea"?

    He responded, "depression and sleep apnea have almost the exact same set of symptoms" and are very related.  How can you not be depressed if you cant breathe all nite and dont get enough oxygen???  

If someone chokes you, wont you almost certainly go into a panic???  Or, are you gonna say, "Aw heck, I dont care if I cant breathe..I will catch up on that next week."  Panic is a symptom of depression.  

Also,  sleep disturbances are consistent with both depression/PTSD and sleep apnea.  

Finally, if you fall asleep during the day at inappropriate times, are you not depressed then, at least??  Or are you jumping around happy while you are asleep??

After I thought about it..the doc is correct.  PTSD/depression/and sleep apnea have overlapping symptoms and you cant always tell which one of these it comes from.