Maura Black: Hi everybody. My
name is Maura Black. Welcome to today's CCK Live under 5. Today, we are discussing PTSD
and sleep apnea. PTSD is post-traumatic stress disorder and it is very common among veterans.
Sleep apnea is a sleep disorder in which a person's breathing is repeatedly interrupted
during the night. There are three main types of sleep apnea. The diagnosis can vary depending
on which type. One type is obstructive sleep apnea. Another is central and another is complex.
Common to all people that are experiencing sleep apnea, the symptoms can include loud snoring,
gasping for air in the middle of the night, waking in the night frequently
hypersomnolence, fatigue during the day, headaches in the morning. Things like that that are due to
broken or interrupted sleep at night. Maura: There are a lot of veterans out
there who are suffering from both conditions based on a study from the National Institute
of Health. Veterans with PTSD have a higher risk of developing sleep apnea
indicating a causal connection between the two. There is also a direct correlation between the
severity of the two types of disabilities. The more severe a person's PTSD symptoms, the more
severe their sleep apnea symptoms could be. This feeds into a primary theory for service connection
that affects veterans who have PTSD that are later seeking service connection for sleep apnea
and that secondary service connection. The National Institute of Health study,
which we will link to the comments so that you can all take a look, indicated that PTSD
and sleep apnea can be aggravated by many of the same factors and that is the reasoning
for the interplay between the two. Maura: The secondary service connection
comes into play because as I said before if a veteran has PTSD and also has sleep apnea
and their PTSD is related to their military service, then it might be possible to argue
that their sleep apnea is due to that PTSD. It is possible to receive a direct service connection
for both conditions. What we know about PTSD and sleep apnoea symptoms and the way that they play
against each other in an overlapping way can open up a pathway to secondary service connection.
The type of evidence that you might need for demonstrating your entitlement to a secondary
service connection. I think in large part in large part it is going to hinge on
a Medical Nexus opinion. Maura: So, in other words,
can you obtain a medical opinion from a doctor or a competent clinician that outlines the way
in which your service-connected PTSD causes or aggravate your sleep apnea. VA will look to that
type of rationale in order to decide whether you are entitled to a secondary service conviction.
So, just a real-life example, if a veteran is service-connected for PTSD
and later develops sleep apnea, the veteran may be able to establish a secondary service
connection for their sleep apnea as either due to their PTSD, in other words, caused by PTSD,
or aggravated by PTSD. It is important to keep in mind that those two pathways under the secondary
service conduction theory are available. So, the question is not just whether PTSD has caused sleep
apnea but also whether PTSD aggravates it. If the symptoms are very severe and PTSD cases, they
can also be very severe in sleep apnea cases. Maura: Medical Nexus evidence is really important
to establish that link, but do not forget that it is also important to obtain lay evidence. If your
sleep apnea, you believe began in service, lay evidence can help to establish that by identifying
the onset. Let us say, that is the first time that you started to experience those classic sleep
apnea symptoms like loud snoring, intermittent waking in the middle of the night, gasping for
air, et cetera, then lay evidence can establish this sleep apnea maybe arose at that time.
VA likes to see specific evidence that relates to your specific condition but general evidence such
as the National Institute of Health study to show a correlation between these two conditions can be
important and persuasive. Maura: This is a quick rundown
of a pretty complex topic, but we have plenty of information on our blog and our website.
So, please feel free to visit us there, and thank you so much for joining us today.