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Sleep apnea is rated under DC 6847 (obstructive) or DC 6840 (central) using the rating criteria at 38 C.F.R. § 4.97. The most common rating is 50% for CPAP use. Sleep apnea is frequently claimed as secondary to PTSD under 38 C.F.R. § 3.310, with published studies linking PTSD to sleep-disordered breathing. Weight gain from psychotropic medications is an additional nexus pathway.
Per M21-1, Part IV.ii.7, the RVSR evaluates the respiratory system based on documented sleep studies (polysomnography) and prescribed treatment. A sleep study documenting an Apnea-Hypopnea Index (AHI) of 5 or greater with prescribed CPAP typically supports a 50% rating. The PACT Act (Public Law 117-168) has expanded presumptive coverage for veterans with toxic exposure-related respiratory conditions.
Asymptomatic but with documented sleep apnea.
Persistent daytime hypersomnolence.
Requires use of a breathing assistance device such as CPAP machine.
Chronic respiratory failure with carbon dioxide retention or cor pulmonale, OR requires tracheostomy.
Under 38 C.F.R. § 3.310