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Writer's pictureKirk Carlson

Top Four Conditions Secondary to Sleep Apnea


Top Four Conditions Secondary to Sleep Apnea

Sleep apnea, a common sleep disorder, is often linked to several secondary health conditions. Some of these conditions are bidirectional, meaning they can aggravate or cause each other. Below, we discuss the top four secondary conditions related to sleep apnea and provide insights into navigating the VA claims process.

1. Hypertension

The most common condition secondary to sleep apnea is hypertension (high blood pressure). Sleep apnea is well-documented as a cause and aggravator of hypertension. Veterans with this condition may be eligible for service connection.

  • VA Ratings: Hypertension is often rated at 0%, which might seem inconsequential. However, if hypertension contributes to a fatal condition such as a heart attack or stroke, surviving family members may qualify for Dependency and Indemnity Compensation (DIC).

  • Presumptive Conditions: Hypertension is linked to conditions such as:

    • Hardening of the kidneys,

    • Heart attacks,

    • Strokes.


      If you have hypertension and a diagnosis of any of these, filing a claim is straightforward due to presumptive status.

2. Asthma

Asthma is another common secondary condition related to sleep apnea, although it poses unique challenges.

  • VA Ratings Overlap: Sleep apnea and asthma are considered respiratory conditions, and their ratings are often combined (pyramided). For instance:

    • Sleep apnea is commonly rated at 50%.

    • Asthma is rated at 30% in most cases.


      In these scenarios, the higher of the two ratings typically applies. However, if your asthma is rated at 60% or higher, it will likely take precedence over the sleep apnea rating.

3. Sinusitis and Rhinitis

While also respiratory conditions, sinusitis and rhinitis are treated differently than asthma in VA ratings.

  • Separate Ratings: Unlike asthma, these conditions are not combined with sleep apnea and are rated independently. For example:

    • Sinusitis can receive a rating of up to 50% for severe cases.

    • Rhinitis is typically rated at 10% or 30%, depending on severity.

If you suffer from these conditions secondary to sleep apnea, they represent opportunities for separate ratings.

4. Conditions Secondary to PTSD

Sleep apnea is often linked to Post-Traumatic Stress Disorder (PTSD), but the relationship doesn't stop there. You can file secondary claims for conditions that arise due to sleep apnea itself, such as hypertension, sinusitis, or other related issues.

  • The key to these claims is the nexus, a medical link between sleep apnea and the secondary condition.

Understanding the VA Claims Process for Secondary Conditions

Filing a claim for conditions secondary to sleep apnea involves specific steps:

  1. The "Big Three" for Secondary Claims:

    • Primary Condition: Your service-connected sleep apnea replaces the "in-service event" requirement.

    • Diagnosis: A current medical diagnosis for the secondary condition is mandatory.

    • Nexus: A medical opinion linking the secondary condition to sleep apnea is critical.

  2. Gathering Evidence:

    • Speak with your primary care provider or specialists about your condition.

    • Ask them to complete a Disability Benefits Questionnaire (DBQ) or note in your medical file the potential link to sleep apnea.

    • Private vs. VA Healthcare: Both options are valid for obtaining medical evidence. If using private care, ensure you upload relevant records directly through Quick Submit on the VA website.

  3. The Importance of a Diagnosis: Without a formal diagnosis for the secondary condition, the claim will not proceed. Always ensure the diagnosis is in place before filing.

Final Thoughts

Sleep apnea can lead to or worsen several serious health conditions, making it essential to understand your rights and options as a veteran. Claims for secondary conditions require careful preparation, strong medical evidence, and a well-established nexus. Be proactive in discussing these connections with your healthcare providers and submitting the necessary documentation.

For more guidance on VA ratings and filing tips, check out additional resources linked below. If you have questions about sleep apnea or related claims, feel free to ask!

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