Quick Answer: Sleep apnea is rated at 50% if you require a continuous positive airway pressure (CPAP) device, making it one of the most valuable single conditions in the VA rating system. You can establish service connection directly (if documented during service) or as a secondary condition to PTSD, anxiety, or other service-connected mental health conditions.
How the VA Rates Sleep Apnea
Sleep apnea is rated under Diagnostic Code 6847. The rating levels are:
| Condition | VA Rating |
|---|---|
| Asymptomatic but with documented sleep disorder breathing | 0% |
| Persistent daytime hypersomnolence | 30% |
| Requires use of a breathing assistance device (CPAP) | 50% |
| Chronic respiratory failure with carbon dioxide retention, cor pulmonale, or requires tracheostomy | 100% |
For most veterans, the CPAP machine prescription is the key to the 50% rating. If your doctor has prescribed CPAP, the VA must rate you at 50%.
Establishing Direct Service Connection
Direct service connection requires showing that your sleep apnea began or was documented during military service. This is relatively rare — most service members don’t get sleep studies while on active duty. However, if any in-service medical records mention sleep disruption, snoring, excessive daytime sleepiness, or breathing issues during sleep, those records support a direct claim.
Secondary Service Connection: The More Common Path
The more common — and often easier — path is secondary service connection. Sleep apnea secondary to PTSD is one of the most well-established secondary chains in the VA system. The medical literature documents that PTSD causes sleep disruption that can progress to sleep apnea, and the VA routinely grants secondary service connection for this relationship.
Other viable secondary connections include:
- Sleep apnea secondary to anxiety or depression
- Sleep apnea secondary to traumatic brain injury (TBI)
- Sleep apnea secondary to obesity caused by service-connected conditions
What You Need to File a Sleep Apnea Claim
- A sleep study (polysomnography) confirming the diagnosis of sleep apnea
- A current prescription for CPAP if applicable
- A nexus letter connecting sleep apnea to your service-connected condition (for secondary claims)
- Medical records documenting your service-connected condition and its link to sleep disruption
Work with an accredited VSO to build the strongest possible sleep apnea claim. This service is free under federal law and California SB 694.
Frequently Asked Questions
Do I need to prove I had sleep apnea while in service?
For secondary service connection, no. You only need to show that your service-connected condition caused or aggravated your sleep apnea — even if the sleep apnea developed after discharge.
What if I have sleep apnea but don’t use CPAP?
If you have diagnosed sleep apnea with persistent daytime hypersomnolence but no CPAP, you’d typically receive a 30% rating. If your doctor recommends CPAP, getting fitted for the device and using it would support the 50% rating.