Brightview Veteran Services logo

How to Get Service Connected for Sleep Apnea

Dr. Jessica R. Allen
How to Get Service Connected for Sleep Apnea

Author: Dr. Jessica R. Allen

Updated: June 27, 2026

Everyone knows that you claim sleep apnea secondary to PTSD and other mental health conditions. However, actually becoming service connected for Obstructive Sleep Apnea (OSA), is perhaps one of the most difficult service-connections to achieve.

There are several necessary steps to become successful with claims process:

1) Sleep Apnea Diagnosis To receive a service-connection for sleep apnea, you must officially have a sleep apnea diagnosis. The only way this can be done is if you complete a sleep study (polysomnography). You may be diagnosed with obstructive, central, or complex sleep apnea.

2) Cause or Aggravation If you were not diagnosed with sleep apnea while in-service, then you will need to claim sleep apnea to a condition for which you are already service connected such as Post Traumatic Stress Disorder (PTSD). We will work with you to determine if your PTSD caused sleep apnea or if your PTSD symptoms are aggravating your sleep apnea.

3) Nexus Letter

With any condition that you are claiming as secondary to another condition, a nexus time is more often than not needed. A nexus letter is written by a physician and it explains the science behind why two medical conditions are connected. The nexus letter also includes details that are specific to your case.

Learn more about sleep apnea nexus letters here.

If you are ready to finally become service connected for sleep apnea, give us a call today (919) 849-8617 or schedule a free phone consultation at this link.

About the Author

This article was written by Jessica Allen, M.D., founder of Brightview Psychiatry Solutions, who personally performs every independent medical examination (IME) and authors every nexus letter the practice issues. The sleep apnea pathways discussed here run squarely through her area of expertise: as a psychiatrist, Dr. Allen evaluates how PTSD, insomnia, and other mental-health conditions disrupt sleep architecture, drive hyperarousal, and — together with psychiatric-medication effects and weight gain — contribute to obstructive sleep apnea. Because the strongest secondary sleep-apnea claims depend on a careful read of both the psychiatric and medical record, opinions are grounded in the veteran's documented history rather than generic templates.

Medical literature

  1. Colvonen PJ, Masino T, Drummond SPA, Myers US, Angkaw AC, Norman SB. Obstructive Sleep Apnea and Posttraumatic Stress Disorder among OEF/OIF/OND Veterans. Journal of Clinical Sleep Medicine. 2015;11(5):513–518. — In Iraq/Afghanistan veterans presenting to a VA PTSD clinic, roughly 69% screened high-risk for OSA, and risk rose with PTSD severity (about a 40% increase in odds of high-risk screening for each clinically significant rise in PTSD symptoms). https://pmc.ncbi.nlm.nih.gov/articles/PMC4410924/
  2. The bi-directional relationship between post-traumatic stress disorder and obstructive sleep apnea and/or insomnia in a large U.S. military cohort (Millennium Cohort Study). Sleep Health. 2022. — Longitudinal evidence of a two-way relationship between PTSD and OSA/insomnia. https://www.sleephealthjournal.org/article/S2352-7218(22)00131-0/fulltext
  3. American Academy of Sleep Medicine. Study finds high risk of sleep apnea in young veterans with PTSD. — Plain-language summary of the Colvonen findings, useful for general readers. https://aasm.org/study-finds-high-risk-of-sleep-apnea-in-young-veterans-with-ptsd/

VA law and regulations

  1. 38 C.F.R. § 3.310 — Secondary service connection, including disabilities caused or aggravated by an already service-connected condition. https://www.ecfr.gov/current/title-38/chapter-I/part-3/subpart-A/subject-group-ECFR1e8c1c1a3d4a4f2/section-3.310
  2. 38 C.F.R. § 4.97, Diagnostic Code 6847 — Current rating criteria for sleep apnea (0%, 30%, 50%, 100%). Note: VA has proposed revising DC 6847, but as of mid-2026 no final rule has taken effect; the current criteria still control. https://www.ecfr.gov/current/title-38/chapter-I/part-4/subpart-B/section-4.97
  3. VAOPGCPREC 1-2017 (Jan. 6, 2017) and Walsh v. Wilkie, 32 Vet. App. 300 (2020) — Establish that obesity can serve as an "intermediate step" between a service-connected disability and sleep apnea under § 3.310(a), by causation or aggravation. This is the key authority for the "service-connected condition → weight gain → OSA" pathway. http://www.uscourts.cavc.gov/documents/WalshEM_18-495.pdf
  4. 38 C.F.R. § 3.102 — Benefit of the doubt; a nexus need only show the link is "at least as likely as not" (≥50% probability).
Book a Consultation