Sleep apnea question

[capitan]

I was granted TDIU P&T. Part of it was sleep apnea 50%. Does that mean they will require me to use a CPAP machine? How do they know if you use it or not? 

[shrekthetank1]

depends on which one you have and if the VA tracks you or not.  Now as far as I know they do not share this with the area that does the decision making.  Mine stopped transmitting a year ago and no one has said anything to me.  

[jamescripps2]

There is a chip in the CPAP machine. The chip transmits data to the VA. After using mine for more than five years I had to go in to raspatory for a face to face. They pulled up my machine on their computer and told me how often I had used it and how often I failed to use it. Next they asked me to make a return appointment and bring the machine in for a fine tuning because they noticed that I was having too many episodes. Before I left the appointment I was told that if I failed to use the machine I would no longer be able to order supplies and to be reinstated would require a new sleep study.

I have sleep apnea and the VA conducted the sleep study. I did fail to use the CPAP for a period of two months because I broke my nose and could not wear the mask. The broken nose was noted and treated at the VA and was verified by respiratory as being the reason for my not using the CPAP during  the period in question. I have never filed on the sleep apnea and it is not service connected, nor do I intend to file on it because I am already at the max of SMC "O" to include R-1 and there would be no gain. 

All of the CPAP readings are a matter of record in your VAMC medical records and the compensation & pension side of the DVA has access to those records. Looking back, I think that if I had been service connected for the sleep apnea, I would have stood a good chance of loosing my rating for failure to use the machine.

I also know that they still track my usage because they called me and told me that I was having fewer events since they fine tuned the machine, and that they had ordered a years worth of supplies for me, filters hoses, reservoirs etc.

I would suspect that if you did loose service connection for failure to use the CPAP, and was ever able to get re instated, it would be at a lesser rate because they are going to reduce the sleep apnea ratings across the board.

 

[pacmanx1]

Disability compensation is based on symptoms and due to the fact that some symptoms are refractory (resistant) to medications and or medical devices I am not sure. Don't get me wrong but the VA could try to reduce a veteran's rating, but it would be a battle. Also due to COVID a lot of VA clinics are having problems maintaining schedules and again, this would be a battle because some veterans choose not to go to the VA for appointments. Yes, they should issue your machine.  

[broncovet]

Yes.   As James Cripps stated, the va knows if you are using your cpap.  If ordered by a doctor, you should use your cpap.  You need it.  

If the mask is uncomfortable, awkward, or does not work for you, go back and your doc or perhaps respiratory therapist can try a different mask.  Or maybe tweak the pounds of air pressure.  You may need a bipap, instead of a cpap, instead.  (for comp purposes, a bipap and cpap are the same).  There are things that can be done to make the cpap more comfortable.  I use the "nasal pillows" (p10) mask.  It pushes air into the nose only, not the mouth, and is a much less instrusive mask than one that covers most of your face.  Those dont work well if you can not/do not breathe out your nose.  I have a spare full face mask for when I have nasal congestion and cant breathe out of my nose.  

It often takes some getting used to to use a cpap.  You should persist.  Its my opinion, if you dont regurarly use your cpap, yes, you could be reduced, as that suggests you dont need it..if you dont use it.  

I use mine every nite, and dont sleep well without it.  It changed my life for the better.  No more falling asleep during the day at inappropriate times.    It also treats my depression..again, poor sleep causes depression.  

And, if you dont sleep well, that is related to depression, too.  My wifes sleep doc pointed out PTSD and sleep apnea have similar symptoms.  

[pacmanx1]

11 hours ago, capitan said:

I was granted TDIU P&T.

Also, because you are rated P & T, it is not likely the VA would try to reduce your rating. 

[brokensoldier244th]

Unless you need to use an alternative device (ive read that some veteran are getting the surgically implanted stimulator if they can't tolerate a CPAP) like a mouthguard insert- im not sure what they are called- you gotta use the 'Pap. I was Dx'd in 2012 after years of continued drowsiness that began affecting my mental and physical health, culminating in me falling asleep at work, and while driving when I was at a light since I was no longer being 'constantly stimulated'. I would sit on the couch in and immediately drop off. 

OSA can kill you, slowly, literally, and one night you just don't wake up because your O2 sats drop far enough.

[capitan]

This from Woods and Woods law firm:  it is important to note that there is no documented case of a veteran losing benefits because they didn’t use their CPAP machine.

 

Is Your CPAP Machine Tracking You? 

Many veterans may worry their CPAP machine is tracking whether they use it or not. Many CPAP machines indeed have smart computer chips in them that keep up to twelve months of data. Some machines even have an attachable modem or are wireless-enabled for data transmission.

In most cases, the VA does not use this data to track whether you use your CPAP machine or not. Instead, your doctor will use this data to check if the settings on your CPAP machine are working for you or if it needs adjustment. What your insurance company may be looking for, however, is a different question.

Will You Lose VA Benefits?

The short answer to whether you’ll lose VA benefits if you don’t use your CPAP machine is no. The VA will not track your compliance, and they will not revoke your disability benefits if you don’t use your machine. However, it is important to use your CPAP machine as prescribed so you can get the best results possible.

[john999]

The device is called "The Inspire stimulator".  I have one implanted.  It is complicated to an extend and I am not sure Medicare pays for it. The VA does them at certain hospitals.  Just look up "Inspire OSA" and that should give you info.  Mine is better than nothing. I could never tolerate the mask.  I tried for years.

[Rattler767]

I am a full mask guy.. I breath through my mouth at night. It makes a big difference when I cant use it. If you are far enough from the VA hospital you could make the send you to Community Care that way its not going directly to the VA. 

[john999]

When you wake up without being able to use the mask do you have a headache?

[broncovet]

I stand corrected.  Woods and Woods law firm is reputable, and they know more than I do.  IF they say so, then you should follow their advice not mine.  

I forget the football players name who had bad apnea, fell asleep and did not wake up.  

Its real.  

I use my cpap every nite.  Without question it saved my life.  I was diagnosed with apnea FIRST by a cardiologist..he knew an enlarged right side of the heart was sleep apnea damage to  the heart.  

He explained the right side of your heart supplies O2 to the lungs.  And, it enlarges if you stop breathing constantly at night, as your o2 level drops the heart tries to compensate. 

Continued non use of the cpap causes the right side of the heart to continue to enlarge, and the heart becomes "unbalanced" often creating afib over time.  

And continued lack of O2 at nite, with afib, can cause sudden death or, damage the heart beyond repair.  

My cardiologist explained he cant make me get apnea treated, but it would likely cause premature death if untreated.  

I decided to get a sleep study, and sure enough, I had apnea.  No suprise to the cardiologist.  So, I treated it with a cpap, per sleep doc order.  It was a struggle at first to get used to it, but worth it.

No, I dont get compensated for OSA.  Its a long story, but its moot as I already have 100 percent plus smc S, so I decided not to appeal..I dont fight VA "for funsies".  If I have nothing to gain, then let another Vet benefits get done in my place.  VA has limited resources, a limited number of people, and lots of Vets seeking benefits.  

[capitan]

I was just recently granted TDIU 100% P&T. The letter says the reason was because, as I claimed, cancer residuals left me too tired and weak to work. They raised my 30% which was already granted for fatigue and daytime sleepiness to 50%. So it looks to me like they granted TDIU for something I already had.  I assume I will be getting a notice to see a doc about cpap. And find out severity and which kind and recommended treatment. I'm still not sure I even have it. When I took the home sleep study, the nasal attachment part of the machine wasn't working. Tried it the next night, still not working..called and they said send it anyway, it probably has all they need for diagnosis. I don't have any trouble breathing or sleeping. But I might have if I have to wear a cpap mask. Bottom line, I will do what I have to to keep the money. Maybe I won't have to do anything.