How to Win Your Sleep Apnea VA Claim in 2025
If you’ve tried to file a sleep apnea claim with the VA, you know the feeling—it’s like they keep moving the goalposts. No matter how much evidence you submit, it often feels like it’s never enough. Veterans send in medical records, buddy statements, and C&P exams, only to get denied for “lack of proof.”
Sleep apnea claims are tough to win, and I’ve been there. The biggest issue? Most vets don’t get diagnosed while in service, so proving it started during your time in the military is tricky. Even with buddy statements or lay evidence, missing documentation in your service records can tank a claim.
On top of that, sleep apnea has many possible causes outside the military. The VA can argue it’s coincidental, and C&P exams vary—one negative result can hurt your case, even if everything else lines up.
I’m Brian, and I have helped many veterans win their sleep apnea case and get the benefits they deserve.
In this guide, I’ll walk you through a straightforward strategy to build a strong claim. I’ll show you how to gather the right service records, understand the process, and avoid wasting time on a denial.
Can You Get VA Disability for Sleep Apnea?
Getting VA disability for sleep apnea isn’t easy, but it’s definitely possible. Thousands of veterans are approved every year, often with high ratings, so it’s worth understanding how it works.
Whether you qualify depends on the type of sleep apnea, how severe your symptoms are, and whether it’s connected to your military service.
Sleep Apnea Types
Most veterans fall into one of three categories:
Obstructive Sleep Apnea (OSA): The most common type, caused by a physical blockage of the airway, often when throat muscles relax during sleep.
Central Sleep Apnea (CSA): Caused by the brain failing to send proper signals to the muscles that control breathing.
Complex or Mixed Sleep Apnea: A combination of OSA and CSA.
For VA claims, OSA is by far the most commonly approved type. CSA and complex sleep apnea can qualify too, but proving service connection is much more difficult.
Primary vs Secondary Service Connection
In general, there are two ways you can prove that your disability was caused or related to your time in service:
Primary Service Connection: Your condition started during service or was directly caused by your time in the military.
Secondary Service Connection: The condition developed because of another disability you've already got service-connected.
Sleep apnea is very rarely approved as a primary service-connected condition because it usually doesn't stem from a single event in service.
Unless you broke your nose, suffered a facial injury, or had repeated sleep problems documented in your service records, it's unlikely you'll be able to prove a direct connection.
Most veterans I know go the secondary route, which is often the best option anyway. Secondary service connection means your sleep apnea was caused or worsened by another condition you already have service-connected.
For example, the VA granted a veteran sleep apnea benefits because his service-connected depression caused weight gain and sleep problems that, in turn, led to his sleep apnea (A25032204).
How the VA Evaluates Sleep Apnea Claims
To get sleep apnea approved as a secondary service-connected condition, the VA looks for clear proof that your other service-connected disability actually caused or worsened it. Here are a few key things they focus on.
Correct Timeline
You need to show that your service-connected condition came first and that your sleep apnea developed or got worse afterward.
For example, if your PTSD started in service in 2010, and you began having noticeable sleep apnea symptoms in 2015, you must demonstrate that to the VA.
Medical Link
The VA needs proof that your secondary condition is actually connected to your sleep apnea.
This usually comes from medical evidence showing how your service-connected condition directly caused or worsened your sleep apnea. Types of medical literature and evidence the VA finds persuasive include:
Peer-reviewed studies showing a physiological link (for example, studies connecting PTSD or depression to disrupted sleep and increased risk of sleep apnea).
Clinical guidelines from organizations like the American Academy of Sleep Medicine or the American Psychiatric Association that discuss how certain conditions can contribute to sleep apnea.
Case studies or cohort studies that demonstrate real-world examples of patients with the same combination of conditions.
Systematic reviews or meta-analyses summarizing multiple studies that link mental health conditions, obesity, or other factors to sleep apnea.
The VA wants diverse, credible evidence and usually doesn’t like it if you repeatedly submit the same type of source, like multiple letters from the same doctor citing the same research.
Mixing peer-reviewed research, clinical guidelines, and expert opinions makes your claim much stronger.
Clear Symptom Documentation
Show how your sleep apnea actually affects you and links to your primary condition. Some of these include:
Medical records
CPAP usage logs
Statements from family, friends, or fellow vets
In addition, it’s even better if you can show symptoms leading up to the official diagnosis, like fatigue or trouble sleeping, plus sleep study results that show your apnea got worse over time.
Alternatives Must Be Ruled Out
The VA wants to make sure your sleep apnea isn’t primarily caused by other factors like obesity, smoking, or unrelated medical issues.
For example, if you are overweight, your doctor can note whether your weight gain was due to your service-connected depression or back injury rather than unrelated lifestyle factors.
What Conditions Can I Link to Sleep Apnea?
Many conditions can be linked to sleep apnea, but some are much easier to get approved for than others.
Just because you’ve heard of a veteran winning a case for a particular condition doesn’t mean that’s typical or easy to replicate.
Each claim depends on strong evidence showing a clear connection between the primary condition and the sleep apnea.
Sleep Apnea & PTSD
PTSD is honestly one of the easier conditions to link to sleep apnea as a secondary condition, but only if you approach it the right way.
One of the best ways I've found is linking PTSD to sleep apnea through weight gain caused by PTSD treatment. This was actually a situation one of my clients recently, and it worked.
In their case, they gained a significant amount of weight while managing PTSD, and the medical research clearly shows weight gain is one of the biggest risk factors for obstructive sleep apnea.
Tips for Linking PTSD to Sleep Apnea:
Document weight gain clearly – Show any significant weight gain that happened after you started PTSD treatment. This helps show that your weight gain occurred due to the medication and not lifestyle factors.
Include past medical records – If you didn’t have weight issues before service and they started afterward, this can be strong evidence that the weight gain wasn’t preexisting.
Avoid admitting pre-existing apnea – Don't claim that PTSD worsened sleep apnea you already had. In these cases, the VA may just assume that your condition was pre-existing and not caused by your time in service at all.
Use a clear chain of events – Make the progression really easy to follow: PTSD diagnosis → treatment → weight gain → sleep apnea symptoms. The clearer this timeline is, the better your chances.
The key to proving sleep apnea is related to PTSD honestly just requires solid documentation and medical evidence showing that connection.
Sleep Apnea & Sinusitis/Rhinitis
Chronic respiratory conditions like sinusitis or rhinitis are honestly some of the stronger ways to link sleep apnea. I've seen this work really well for a lot of veterans.
Blocked or inflamed airways directly mess with your breathing during sleep, causing OSA. These airway issues lead to breathing interruptions, which are basically the hallmark of sleep apnea.
This connection is much more straightforward than indirect links like PTSD, and honestly, it's easier to prove.
To successfully link your sleep apnea to Rhinitis, you'll need the following:
Include ENT evaluations – Get documentation from an ENT showing chronic sinusitis or rhinitis and any impact on your breathing.
Provide sleep studies showing airway obstruction – Make sure your studies explicitly show how nasal or airway issues contribute to obstructive sleep apnea. The more specific, the better.
Cite supporting medical literature – Reference studies that link chronic nasal or airway conditions to obstructive sleep apnea. The VA likes it when you do your own research because it shows you understand your case and are confident in it. In addition, there’s no one-size-fits-all approach for medical evidence.
Avoid duplicating symptoms – Make sure symptoms like shortness of breath aren't already rated under sinusitis or rhinitis. The VA calls this “pyramiding” and they won't compensate for the same symptom twice. In cases like these, they usually just take the higher rating of the two.
Lay or buddy statements are honestly really useful if your service records don't fully document your nasal or breathing issues. I'll cover these in detail later, but trust me, they can come in really handy when other evidence is lacking.
Sleep Apnea &Traumatic Brain Injury
I've helped a lot of veterans navigate this connection, and honestly, linking Obstructive Sleep Apnea (OSA) to a service-connected TBI is totally doable when you've got medical evidence showing that your TBI caused or made your sleep apnea worse.
Sleep apnea develops after TBI more often than you'd think because brain injury can mess with the nerves and muscles that control your airway during sleep, leading to that obstruction.
This connection is well-recognized in medical literature and VA guidelines, so a secondary claim is definitely feasible if you can establish a clear timeline and medical connection.
To strengthen your claim, I'd focus on these areas:
Include neuro evaluations – Get VA or private records that show your TBI diagnosis, any cognitive deficits, and notes on nerve or muscle issues affecting your breathing.
Document the incident – Really detail that service-related TBI event (you know, blast, fall, head trauma) and those immediate symptoms that could later contribute to OSA.
Use expert opinions linking TBI to OSA – Getting a sleep specialist or neurologist to explain how your brain injury affected airway control during sleep, include that reasoning. It often holds much more weight than a normal doctor.
Provide long-term observations – Submit lay or buddy statements noting persistent sleep problems that started after your TBI, reinforcing that these symptoms weren't there before the injury.
When all of these pieces are in place, the VA can recognize OSA as secondary to TBI, meaning it's caused or aggravated by your primary service-connected condition.
Proving direct service connection for sleep apnea is also possible if your medical evidence shows the condition began or got worse due to a service-related TBI.
Evidence You Need to Win Your Claim
Once you know which route you're taking, the next step is gathering solid evidence. To successfully claim sleep apnea, you've got to provide thorough documentation, including medical records, sleep studies, and nexus letters.
Most approved claims I've seen have at least a DBQ that clearly documents the condition and a nexus letter with a medical opinion.
In addition, testimony in the form of buddy/lay statements can make your case even stronger.
Using the DBQ Form
A DBQ, or Disability Benefits Questionnaire, is a standardized medical form that gets completed by a qualified doctor who documents your diagnosis, how severe your symptoms are, and how the condition affects your daily life.
How you answer each question can really affect the VA's decision. Here's what I'd include in the major sections.
SECTION I – Diagnosis & Medical History
Tips:
Give a clear, unambiguous diagnosis of sleep apnea (Obstructive, Central, or Mixed).
Include ICD codes if you've got them available. Sleep apnea gets rated under VA diagnostic code 6847, so including this code can help clarify things for the VA.
Give a concise history: onset, progression, treatments, and relevant medications.
Include sleep study confirmation.
SECTION II – Findings, Symptoms & CPAP Use
Tips:
Document all your symptoms (daytime sleepiness, chronic respiratory issues, cor pulmonale) and their severity with concrete examples.
If you use a CPAP, include it and explain why it's necessary, since simply having a prescription honestly might not be enough.
Describe how sleep apnea affects your daily life, work, and safety.
SECTION III – Diagnostic Testing
Tips:
Include full sleep study details: date, facility, AHI, oxygen desaturation, and follow-ups.
List multiple studies if you've got them available to show trends over time.
Include other relevant tests like pulmonary function or overnight oximetry.
SECTION IV – Examiner Certification & Remarks
Tips:
Make sure all examiner information is complete: signature, license, NPI, specialty, and date.
Use the remarks section to clarify unusual circumstances or provide extra context.
The VA provides an official DBQ for sleep apnea, so you can see exactly what to expect. I'd recommend reviewing it beforehand.
Getting a Nexus Letter
A nexus letter is a medical opinion written by a qualified doctor that explains why your condition was caused or aggravated by your time in service.
Some claims don't need a nexus letter, but for sleep apnea, that couldn’t be further from the truth.
I'd recommend reading our full guide on nexus letters, as this section will only cover a few key points specifically related to sleep apnea.
For sleep apnea nexus letters, here are a few key points to know:
A sleep apnea Nexus Letter is a key piece of medical evidence showing causation.
It links your sleep apnea to your military service or another service-connected condition.
Sleep apnea can develop for many reasons outside of service, so having a strong letter is critical.
A good Nexus Letter shows the VA the connection to your service and helps rule out other causes.
For sleep apnea nexus letters, I'd highly recommend the letter from a sleep specialist. Their expertise carries way more weight than a general practitioner or nurse.
Buddy & Lay Statements
If your symptoms weren't fully documented or your medical records are incomplete, including buddy letters or lay statements is essential - trust me on this.
These firsthand accounts fill in the gaps and provide the VA with real-world evidence that your sleep apnea symptoms existed and impacted your daily life. Buddy letters and lay statements are similar, but there are a few important distinctions
Buddy Letter – A written account from a fellow service member who personally witnessed your sleep issues or symptoms during your military service.
Lay Statement – A written account from a spouse, family member, or friend who observed your struggles outside of military service.
While these statements can be really helpful, they aren't always required. If you already have strong medical records and evidence, you don't need to worry excessively. That said, there's never such a thing as too much supporting evidence.
If you want to submit a buddy or lay statement, you can find step-by-step guidance on the VA’s website.
VA Ratings for Sleep Apnea
The VA bases ratings primarily on the severity of your symptoms and whether you require treatment, especially with medical devices or if the condition affects daily life.
Your sleep apnea VA rating will determine the level of VA disability ratings assigned to you and the amount of VA benefits you may receive.
Checking the 38 CFR rating criteria can help you understand what rating you might qualify for and what evidence the VA considers most important, so you can make sure your claim is as strong as possible.
Daytime Sleepiness (Hypersomnia)
Hypersomnia is that brutal excessive daytime sleepiness you get from lousy sleep at night. It'll mess with your work, your driving, and honestly, your whole quality of life.
Here's the thing though—proving hypersomnia can be really tricky because "excessive sleepiness" sounds pretty vague, and the VA wants concrete examples of how it's actually impacting your daily functioning.
From what I've seen, veterans dealing with serious daytime sleepiness often end up with ratings around 30 percent, depending on how severe it is and what functional limitations you're dealing with.
Here's how I'd recommend demonstrating it effectively:
Keep a detailed symptom journal tracking your daytime drowsiness, naps, and those episodes where you just fall asleep.
Get witness statements from family, roommates, or coworkers who can describe the sleepiness they've observed and how it's impacting you.
Make sure to highlight safety risks—like having trouble driving, operating machinery, or performing critical tasks.
Include medical documentation from a sleep specialist or your primary care doctor that confirms the severity and functional impairment.
Document work or school impacts, like missed deadlines, decreased productivity, or frequent errors because of sleepiness.
CPAP Treatment
A CPAP machine helps keep your airway open while you sleep, and honestly, needing one shows that your sleep apnea is severe enough to require treatment.
Veterans who use a CPAP typically start with a 50 percent rating, which can go up depending on how severe your symptoms are.
Important: Just having a CPAP prescription sometimes isn't enough. The VA wants to see why you need it and how it's helping manage your sleep apnea.
Here's how I'd demonstrate the need for a CPAP:
Provide medical notes that explain your symptoms—fatigue, daytime sleepiness, snoring, etc.—and how they're helped by CPAP use.
Include sleep study results that show just how severe your sleep apnea actually is.
Show records of CPAP prescriptions and any follow-up notes from your doctor recommending its use.
Document any attempts at alternative treatments and why they just weren't cutting it.
Include firsthand accounts (buddy or lay statements) describing how your symptoms impact daily life without CPAP.
Like I mentioned earlier, you can't get separate disability ratings for the same symptom.
For example, if you're already getting benefits for using a CPAP due to asthma or allergies, you can't get an additional rating for that same symptom under sleep apnea.
Chronic Respiratory Failure
In rare cases, sleep apnea can lead to chronic respiratory failure or you might need supplemental oxygen at night.
These extreme cases may qualify for the maximum 100 percent VA rating. While most veterans don't reach this level, it's definitely possible if the condition is severe and well-documented.
Here's how I'd demonstrate it effectively:
Include pulmonary function tests or overnight oximetry showing oxygen desaturation.
Provide sleep study results documenting severity and nighttime breathing issues.
Submit medical notes or prescriptions for supplemental oxygen use.
Explain the daily impact on your functioning—like limited physical activity, difficulty sleeping without oxygen, or health complications.
Highlight any hospitalizations or emergency interventions related to severe apnea.
Why the VA Denies Sleep Apnea Claims
In many cases, even when you have what seems like a slam-dunk case, the VA can still deny your sleep apnea claim.
Most of the time, it's not because your condition isn't real, but because of common mistakes or gaps in evidence that could've been avoided.
Trust me, understanding why these denials happen can save you from making the same mistakes I've seen countless veterans make, and it'll definitely boost your chances of getting approved.
Failing to Prepare for C&P Exam
Here's the thing that really gets me—one of the biggest reasons I've seen veterans crash and burn with their VA claims is not preparing properly for the C&P exam. And honestly? Sometimes it's not even your fault.
Some of my clients have dealt with C&P examiners who seemed like they were just going through the motions, not really digging deep into your case or understanding what you're actually dealing with.
Ways I've learned to prepare for your C&P exam:
Review all your medical records and bring any supporting documentation you can get your hands on.
Know your symptoms inside and out, and be ready to explain exactly how they mess with your daily life—get specific about it.
Practice explaining your condition clearly and consistently, because you'll need to tell your story well.
Bring a buddy or lay statement if they'll let you as this helps back up what you're saying.
Here's what really stings though—if your C&P exam ends up contradicting your nexus letter, DBQ, or other evidence you've worked hard to gather, it becomes incredibly difficult to override that examiner's opinion.
When this happens to you (and I hope it doesn't), your best bet is usually to take your claim to a Higher-Level Review (HLR) rather than trying to fight that exam's conclusions through the regular appeals process.
There is No Service Connection
This one's tough to swallow, but honestly, one of the biggest reasons I've seen sleep apnea claims get shot down is because the condition wasn't actually caused by military service—even when the veteran was absolutely convinced it was.
Sometimes your sleep issues just… happened, and no amount of hoping or wishing it started during your time in service is going to change that reality.
The VA can be incredibly frustrating, and yes, they're often way too strict about everything. But every now and then, they actually get it right (go figure).
Other common causes of sleep apnea I've seen veterans need to consider:
Genetics – if your family has a history of sleep apnea, that might be playing a bigger role than you think.
Age and gender – sleep apnea hits older adults and men more often, just the way it is.
Nasal or airway issues – things like chronic congestion, a deviated septum, or other structural problems you might not even realize you have.
Lifestyle factors – alcohol use, smoking, or sedative medications can all contribute to this.
Final Thoughts on Winning Sleep Apnea Claim
In the end, winning a sleep apnea claim comes down to building a clear, well-supported connection between your condition and your service or another service-connected disability.
Make sure your timeline is easy to follow, your medical evidence is thorough, and your lay statements back up your story with credible, firsthand details about how your symptoms developed and affect your daily life.
The stronger and more consistent your evidence is, the harder it is for the VA to deny your claim.
Take the time to organize everything clearly and don’t be afraid to seek help if you need it — doing so can make the difference between a denied claim and the benefits you’ve earned.
FAQ
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To file a claim for sleep apnea, submit VA Form 21-526EZ online through VA.gov, by mail, or in person at a VA regional office. Include medical records, a sleep study confirming the diagnosis, and any evidence linking it to your service or a service-connected condition
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While it’s technically possible to fail a VA sleep apnea test by staying awake, using stimulants, or altering your sleep habits before the study, doing so is strongly discouraged. These actions can lead to inaccurate results, delay your diagnosis, and hurt your claim. It’s always better to be honest and let the test reflect your true condition so you can receive the proper care and benefits
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The VA is changing the way it rates sleep apnea, which will be based on how severe it is and how much it impacts your daily life. Ratings range from 0% if it’s diagnosed but causes no symptoms, up to 100% if it results in chronic respiratory failure or requires a tracheostomy. Most veterans who use a CPAP machine receive a 50% rating
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the best approach I found is through a secondary service connection. What you're basically doing is showing that another service-related condition—like PTSD, rhinitis, or sinusitis—actually caused or contributed to your sleep apnea. Trust me, this connection can make all the difference in getting your claim approved.
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several medical conditions are commonly connected to sleep apnea. The big ones include PTSD, chronic rhinitis, sinusitis, obesity, hypertension, and heart disease. For us veterans especially, sleep apnea claims often work best when they're filed as secondary to PTSD or respiratory issues that developed during service. The connection between these conditions and sleep apnea is well-documented, which definitely works in your favor when building your case.
