For many veterans, posttraumatic stress disorder (often referred to as PTSD) is a heavy burden, presenting a range of symptoms that can significantly impair daily life.
Among these symptoms, there’s an emerging recognition in clinical circles of the relationship between PTSD and a common sleep disorder: sleep apnea, particularly its most prevalent type, obstructive sleep apnea.
This relationship is more than mere coincidence, and for veterans seeking VA disability benefits, understanding this connection can be crucial.
While it’s widely acknowledged in sleep medicine that there’s a link between sleep disturbances and mental health conditions, pinpointing sleep apnea secondary to PTSD presents its challenges.
The VA often requires a robust array of evidence when assessing a VA disability claim, especially when it comes to connecting these two conditions.
Nevertheless, this article hopes to shed light on this connection, providing guidance on how one might establish sleep apnea secondary to PTSD for VA disability benefits purposes.
It’s essential for veterans to realize that while sleep apnea can severely impact sleep quality and overall health, when connected to PTSD, it paints a picture of a complex interplay of physical and psychological symptoms.
As we delve deeper, we’ll also explore how sleep apnea might be linked to other mental health disorders and how veterans can navigate the often intricate path of seeking disability benefits for this secondary condition.
Understanding PTSD: A Quick Overview
Posttraumatic stress disorder, often abbreviated as PTSD, is a mental health condition that develops in response to witnessing or experiencing a traumatic event.
This can encompass various experiences from intense combat situations veterans often face, to traumatic accidents, natural disasters, or personal assaults.
Core Symptoms of PTSD
- Reliving the traumatic event: This is frequently characterized by flashbacks, nightmares, or distressing thoughts about the event, making it challenging to find restful sleep.
- Avoidance and numbing: Individuals with PTSD might avoid places, people, or activities that remind them of the trauma. This can also manifest as a feeling of detachment from others and an emotional numbing.
- Increased arousal: Symptoms in this category include difficulty sleeping, irritability or outbursts of anger, difficulty concentrating, and being easily startled or feeling tense.
- Negative alterations in beliefs and feelings: This might involve persistent and distorted blame of oneself or others, estrangement from others, or a markedly diminished interest in activities.
- Hyper-vigilance: This symptom is marked by an increased state of sensory sensitivity, often leading to sleep disturbances and deprivation.
For veterans, PTSD symptoms can be particularly pronounced, given the unique stresses and challenges they might have faced during their service. While PTSD is a psychological condition, its impact is not limited to one’s mental health.
The disorder has a ripple effect, causing physical health issues and aggravating pre-existing conditions.
One significant concern stemming from PTSD is the disruption of healthy sleep patterns.
Consistent sleep deprivation and disturbances, like those caused by PTSD, put individuals at high risk for a variety of health complications, including sleep disorders like sleep apnea.
Want to learn more about PTSD? Check out our articles below.


The Relationship Between Sleep Apnea and PTSD
Sleep plays a pivotal role in maintaining our physical and mental well-being.
However, for veterans grappling with posttraumatic stress disorder (PTSD), achieving restorative sleep can be a daunting challenge.
Research has increasingly highlighted a concerning connection between PTSD and the onset of sleep disorders, notably sleep apnea.
What is Sleep Apnea?
Sleep apnea is a sleep disorder marked by repeated interruptions in breathing during sleep.
These interruptions can last from a few seconds to minutes and can occur numerous times in an hour.
There are primarily three types of sleep apnea: obstructive sleep apnea (the most common), central sleep apnea, and complex sleep apnea syndrome.
Want to learn more about sleep apnea? Check out our guide below.
A Guide to VA Ratings for Sleep Apnea
How Does PTSD Influence Sleep Apnea?
A recent study found that almost 60% of veterans with PTSD also suffer from sleep apnea.
It also can cause many or all of the following.
Sleep disturbances
One of the hallmarks of PTSD is the prevalence of sleep problems.
Nightmares, flashbacks, and hyper-vigilance can disrupt the sleep cycle, contributing to sleep deprivation and creating an environment conducive to sleep disorders like sleep apnea.
Physiological changes
PTSD can result in physiological changes in the body.
Chronic stress and anxiety associated with PTSD can alter the body’s response mechanisms, potentially affecting respiratory patterns and leading to conditions like obstructive sleep apnea.
Weight gain
While not direct, there’s a potential link between PTSD and weight gain due to lifestyle changes, medication side effects, or coping mechanisms such as overeating.
Being overweight increases the risk of developing obstructive sleep apnea, as excess fat deposits around the upper airway can obstruct breathing.
How Sleep Apnea is Treated
There are many ways to treat sleep apnea, including lifestyle changes like losing weight, diet changes and/or quitting smoking and substance abuse.
Additionally, using a Continuous Positive Airway Pressure (CPAP) machine at night or surgery (also known as CPAP therapy).
If you were diagnosed with obstructive sleep apnea before the Philips CPAP Recall, your doctor has likely suggested you use a CPAP machine at night in the past; that’s great for establishing your VA disability benefits.
It can help your VA disability claim if you can show that your doctor has prescribed at least one of these sleep disturbances treatments and that you are following directions regularly (CPAP adherence, taking prescribed meds, etc.).
Why Veterans Should Be Concerned
For veterans, the stakes are high. Untreated sleep apnea can lead to a plethora of health complications, ranging from cardiovascular problems to issues like erectile dysfunction.
Furthermore, the combination of PTSD symptoms and the chronic fatigue associated with sleep apnea can significantly diminish quality of life.
Veterans with PTSD are at a higher risk of developing sleep apnea secondary to their psychological condition.
Recognizing this connection is pivotal for seeking appropriate treatment and, for those looking to file a VA disability claim, essential for understanding the nuances of disability benefits.
In the following sections, we will guide veterans through the process of establishing sleep apnea secondary to PTSD, emphasizing the importance of clinical sleep medicine evaluations and detailing the necessary steps to secure VA disability benefits.
Interested in filing for sleep apnea secondary to PTSD but have been denied? Contact us today!
Can Sleep Apnea Be Service Connected Secondary to Other Mental Health Conditions?
The quest for VA disability benefits can be intricate, especially when the medical landscape links multiple conditions.
Veterans often question whether sleep apnea can be service-connected secondary to mental health conditions other than PTSD, like depression and anxiety.
To address this, it’s essential to understand the complexities surrounding the relationship between sleep disorders and mental health.
If you are interested in learning about other mental health disorders you could consider when applying for secondary conditions, check out our extensive guide below.
Understanding the Difference Between Mental Health Disorders
Understanding the Link with Obesity
Sleep apnea, especially obstructive sleep apnea, is often correlated with weight gain and/or obesity.
Now, why does obesity factor into this discussion?
Some mental health conditions, due to medication side effects, lifestyle changes, or coping mechanisms, can result in weight gain.
This increase in weight can then heighten the risk of developing sleep disorders such as sleep apnea.
Criteria for Establishing Connection
To ascertain if sleep apnea can be service-connected secondary to a ratable mental health condition, the following criteria must be satisfied:
- The service-connected mental health condition, be it PTSD or another disorder, should be a direct cause for the veteran’s weight gain or obesity.
- This obesity, as an aftermath of the service-connected disorder, should significantly factor into the onset or aggravation of sleep apnea.
- The sleep apnea symptoms should not have manifested if not for the obesity triggered or aggravated by the service-connected mental health condition.
The Role of Medical Documentation
When pursuing a VA claim for sleep apnea secondary to a mental health condition, it’s pivotal to have substantial medical documentation.
Incidental references to weight gain or sleep disturbances aren’t sufficient.
Comprehensive evaluations from clinical sleep medicine experts and psychiatric professionals can strengthen a veteran’s case.
Want to learn more about the importance of evidence? Check out our blog post!

The Key Types of Evidence in VA Disability Benefits Claims
VA’s Stance on Obesity
It’s imperative to note that the Veterans Affairs does not recognize obesity alone as a “disability” for service connection purposes.
However, it can be an “intermediate step” bridging the service-connected disability (like PTSD or another mental health condition) and a consequential condition like sleep apnea.
Remember that sleep apnea is also secondary to hypertension.
Navigating VA Disability Benefits
When filing a VA disability claim for sleep apnea secondary to a mental health condition, it’s essential to clearly delineate the chain of events linking the primary service-connected disability, the subsequent weight gain or obesity, and the resulting sleep disorder.
Understanding VA form requirements and having a grasp of disability compensation nuances can be invaluable in these instances.
While establishing sleep apnea secondary to mental health conditions other than PTSD can be challenging, it’s not impossible.
With the right documentation and a comprehensive understanding of the criteria, veterans can navigate the complexities of the VA system and obtain the disability benefits they rightly deserve.
Proving Sleep Apnea Secondary to PTSD
Navigating the labyrinthine process of securing VA disability benefits can be challenging, especially when establishing service connections between conditions like sleep apnea and posttraumatic stress disorder (PTSD).
Sleep apnea secondary to PTSD is a concept that’s often met with skepticism due to the intricate nature of these disorders and their interconnections.
Nonetheless, for veterans suffering from these conditions, understanding the linkage and establishing proof is crucial.
Documentation Is Key
To bolster a VA disability claim, veterans must provide comprehensive medical documentation that illustrates the link between their PTSD symptoms and sleep apnea.
This might include records highlighting sleep disturbances, sleep studies indicating obstructive sleep apnea, or notes from clinical sleep medicine specialists linking the two conditions.
Read about the importance of lay evidence in the article below.
The Importance of Lay Evidence
Highlight the Traumatic Event
Emphasizing the traumatic event that led to PTSD and its subsequent impact on sleep health can provide a clearer narrative.
Detailed accounts of nightmares, flashbacks, or other PTSD symptom severity that disrupts rem sleep or leads to sleep deprivation can be beneficial.
Show the Chain of Causation
While it might seem daunting, establishing a clear line of causation between PTSD, potential weight gain (or other intermediate factors), and the onset or worsening of sleep apnea can fortify the claim.
This can involve showing how PTSD led to behaviors or medications causing weight gain, subsequently increasing the risk for sleep apnea.
Expert Testimonies
Collaborating with medical experts who can testify on the relationship between PTSD and sleep disorders can provide weight to a claim.
Statements from specialists in sleep medicine or psychiatry can be instrumental.
An example of this might be a nexus letter, written by a medical professional.
Learn more about getting a winning nexus letter in our guide below.
The Key to a Winning Nexus Letter
Stay Updated on VA Policies
The landscape of VA disability benefits is continually evolving. Veterans should stay informed about any changes in VA policies regarding disability compensation for conditions like sleep apnea secondary to PTSD.
For many veterans, the intersection of sleep apnea and PTSD is a lived reality.
Understanding this interplay is not just essential for personal health but also for navigating the VA disability system.
The journey of securing disability benefits for conditions like sleep apnea secondary to PTSD might seem strenuous, but with meticulous documentation and a clear understanding of the criteria, it becomes surmountable.
Have Questions About Understanding How the Claims Process Works?
Hill & Ponton are here to support you with getting started with your claim.
If you are intending to appeal a denied claim, you can contact us for an evaluation and we can help you with this process.
However, if you are considering filing an initial claim, or even if you are interested in learning about the appeals process, we offer a free ebook to get you started on the right foot!
The Road to VA Compensation Benefits will help break down the claims process from start to finish. Click the link below to learn more.