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Sleep apnea secondary to Fibromyalgia


PEACHES1962

Question

I was surprised sleep apnea could be a secondary condition connected to fibromyalgia.  I just had a C&P exam and it looks like a favorable outcome. I have attached the documents. This might be helpful to someone.

 

Sleep Apnea DBQ.pdf Medical Opinion DBQ (Secondary Service Connection).pdf

Edited by PEACHES1962
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Correct! The nexus on the Medical Opinion DBQ is pretty solid (only leading paragraph posted below). That would be a great study for other veterans to use if their doc is skeptical. 

Quote

Patients with fibromyalgia have a tenfold increase in sleep-disordered breathing, including obstructive sleep apnea. A study published by the National Institute of Health on 05/01/2017 Titled: "Is There a Link Between Obstructive Sleep Apnea Syndrome and Fibromyalgia Syndrome" notes a Detection of OSAS in 50% of the patients with FMS. Therefore it is more likely than not.

 

Just be certain to remain compliant in using the CPAP machine. The VA can check the data card and tell if you are using it regularly. I had to switch from the full nose/mouth mask to the nasal cushion because I was always taking the full one off during the middle of the night. 

 

For reference:

§4.71a   Schedule of ratings—musculoskeletal system.

Quote
5025   Fibromyalgia (fibrositis, primary fibromyalgia syndrome)  
With widespread musculoskeletal pain and tender points, with or without associated fatigue, sleep disturbance, stiffness, paresthesias, headache, irritable bowel symptoms, depression, anxiety, or Raynaud's-like symptoms:  
That are constant, or nearly so, and refractory to therapy 40
That are episodic, with exacerbations often precipitated by environmental or emotional stress or by overexertion, but that are present more than one-third of the time 20
That require continuous medication for control 10
Note: Widespread pain means pain in both the left and right sides of the body, that is both above and below the waist, and that affects both the axial skeleton (i.e., cervical spine, anterior chest, thoracic spine, or low back) and the extremities.

 

§4.97   Schedule of ratings—respiratory system.

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

 

 

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4 hours ago, Vync said:

Just be certain to remain compliant in using the CPAP machine. The VA can check the data card and tell if you are using it regularly.

Vync, I don't disagree with you but no where does it states you must be using the CPAP to maintain SA as a disability. You only need to have one prescribed as needing one. Now with that being said I highly recommend using your CPAP if for no other reason to help your condition.

44 minutes ago, vetquest said:

I had to go to the full mask because I was removing the nosepiece at night.

I have been using my CPAP machince since 2015 and I am still struggling to get the right mask to work for me. It seems like no matter what I try I can only use it for 5 hours more or less per night. I have a hard time sleeping with it. Having scolosis does not help. 

I have thought about going to see my dentist to see if they could make me an appliance to use at night to help me breathe better.

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Paul Vync is correct about those VA Prescribe  C-pap machines do have a memory card in them and after 30 days if one being issued the Vet is suppose to bring the machine in so the Sleep Clinic Dr can check how many Apneas he/she had within those 30 days , this is also when the can tell how many hours the Veteran has used the machine

Any pressure on the machine that needs to be raised or conform to the Veterans sleep patter will be adjusted  it could very well save a life, after this   then usually the veteran sleeps better and nothing else is mention.

 Unless the Veteran needs more adjustments  but it's up to the Veteran to let the sleep clinic Know.

This may or may not have anything to do with our claims but if the R.O. Finds out that he is NOT using his VA  Prescribe C-Pap machine  could very well cause the Veteran problems  if he is S.C. and given a Rating.

If your having problems with your face mask  go to your sleep clinic  if you have a VA Prescribe C-pap?

   let them know your having problems adjusting to the Face Mask...they have several other MASK and nose pieces you can try..also they have face mask Pads (cloth type ) to cover your mouth  if the mask irritates your skin.  this would be the full Face Mask Type

sounds like you may need to try the Noise Piese a band that just fits around your head and only has the hose hooked up to the nose piece that fits in your nostrils   kinda like they use at the Hospital   it just goes direct to your nose but the tube don't fit behind your ears.

It does take time to get use to wearing one and if you have Sleep Apnea (no matter how Bad)This face mask or nose Piece could very well save your life.

Its very important to your well being to get this Issue solved, please do so ASAP.

I could not function without using my VA C-Pap but it did take a while and adjustments before I did start sleeping better  But I also  have Chronic PTSD and I have night mares 2 to 3 times weekly and I usually knock my mask off  but my wife lets me know and calms me back down. re fit the mask and go back to sleep

  I take a lot of sleep meds but it don't stop the NM's  I don't want to mention this to the MH they would just throw more sleep meds at me and I  think I already take enough of those.

Good Luck with your C-PAP Issues 

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17 hours ago, paulstrgn said:

Vync, I don't disagree with you but no where does it states you must be using the CPAP to maintain SA as a disability. You only need to have one prescribed as needing one. Now with that being said I highly recommend using your CPAP if for no other reason to help your condition.

It's part of the 50% rating - the "requires use of" part. I just wanted to suggest that if someone is 50% for SA and the rating is not considered stabilized, and the VA reads the cards from the system to find non-compliance, they may be subject to a proposal to re-eval/reduce.

§4.97   Schedule of ratings—respiratory system.

  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

 

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17 hours ago, paulstrgn said:

I have been using my CPAP machince since 2015 and I am still struggling to get the right mask to work for me. It seems like no matter what I try I can only use it for 5 hours more or less per night. I have a hard time sleeping with it. Having scolosis does not help. 

I have thought about going to see my dentist to see if they could make me an appliance to use at night to help me breathe better.

Oof, that sucks. I know I am lucky to get 4 or 5 hours after my heart attack, even with the CPAP.

I found it helpful to do a saline nasal rinse and taking tylenol and a muscle relaxer nightly before bed. Having a dentist make you a night guard/bite guard/splint to wear at night can really help. I got one made and it made a big difference. I chewed through the first two and they made me an extra thick one. I'm SC for TMJ and was grinding my teeth and waking up in pain from wearing the bear trap CPAP harness. I switched to the nasal pillow and keep my mouth closed while sleeping. The big difference came when I had sinus surgery to straighten the septum and remove polyps. After recovering, I can sleep a lot better than before. My wife also forces me to keep the mask on at night because I don't snore if I do.

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