Diagnostic Code 6847 · 38 CFR §4.97
Sleep apnea is a condition where breathing repeatedly stops and starts during sleep. The most common form among veterans is obstructive sleep apnea (OSA), where the airway becomes physically blocked during sleep. Central sleep apnea, where the brain does not properly signal the breathing muscles, is less common but also ratable. Diagnosis requires a sleep study (polysomnography) that measures the apnea-hypopnea index (AHI). Sleep apnea is one of the fastest-growing VA disability claims and is frequently claimed as secondary to PTSD, weight gain from medications, or other service-connected conditions.
| Rating | Criteria |
|---|---|
| 0% | Asymptomatic but with documented sleep apnea diagnosis from a sleep study. |
| 30% | Persistent daytime hypersomnolence (excessive daytime sleepiness) that is not adequately managed by other measures. |
| 50% | Requires use of a breathing assistance device such as a CPAP (continuous positive airway pressure) machine. This is the most common rating for sleep apnea because the standard treatment for moderate-to-severe OSA is CPAP therapy. If you have been prescribed a CPAP, you meet the criteria for 50%. |
| 100% | Chronic respiratory failure with carbon dioxide retention, requiring the need for a tracheostomy, or cor pulmonale (right-sided heart failure secondary to the lung condition). |
You will need: (1) a current diagnosis of sleep apnea confirmed by a sleep study showing your AHI score, (2) evidence of a nexus to military service — either direct (symptoms began during service) or secondary (caused or aggravated by a service-connected condition like PTSD, weight gain from medications, or a nasal/sinus condition), and (3) documentation of your prescribed treatment, particularly if you use a CPAP machine. The sleep study results and the CPAP prescription are the two most important pieces of evidence for determining your rating level. If claiming secondary to another condition, a nexus letter from a medical provider explaining the connection is strongly recommended.
The 50% criteria requires use of a "breathing assistance device" such as a CPAP machine. If you have been prescribed a CPAP (or BiPAP, APAP, or similar device) for your sleep apnea, you meet this criteria. An oral appliance (dental device) may also qualify, though this is sometimes contested — having the CPAP prescription is the clearest path to 50%.
Yes, and this is one of the most common secondary claims filed. Medical research has established links between PTSD and the development or aggravation of sleep apnea. A nexus letter from a medical provider explaining how your PTSD contributes to your sleep apnea is strongly recommended for this claim.
Most veterans are not diagnosed during service. You can still establish service connection through a secondary claim (linking it to another service-connected condition) or through a direct claim if you can show symptoms began during or shortly after service. Buddy statements from spouses or roommates who observed snoring, gasping, or breathing pauses during sleep can support your claim.
Potentially. The 50% rating is based on requiring a breathing assistance device. If at a future re-examination the VA determines you no longer require the device, your rating could be reduced. However, ratings that have been in place for 5 or more years receive additional procedural protections before reduction.