{"page":"https://casescribe.ai/explorer/secondary/sleep-apnea-secondary-to-psychiatric-disorder","generated_at":"2026-10-03T18:34:31.043Z","data_as_of":{"decisions":944125,"first_year":2017,"last_year":2026,"latest_decision":"2026-04-30","cfr":"2026-10-01","m21":"2026-09-29"},"about":{"publisher":"CaseScribe AI (VA Law Explorer)","source":"Public Board of Veterans' Appeals decisions (appeals of VA decisions, not VA's first decisions), M21-1 Adjudication Procedures Manual, 38 CFR Parts 3 and 4.","method":"Outcomes are issue-level: each condition the Board decided in a decision counts once. Decision data is extracted by AI and can contain errors. Rates describe past appeals and do not predict any claim.","disclaimer":"For research only. CaseScribe AI is not a law firm and this is not legal advice. Verify figures against the source decisions and regulations.","attribution":"Cite as: VA Law Explorer, CaseScribe AI, with the page URL."},"data":{"claim":"Sleep apnea secondary to a psychiatric disorder","secondary_condition":"Sleep apnea","service_connected_disability":"a psychiatric disorder","decisions":5568,"years":"2017-2026","granted_pct":33.4,"denied_pct":11.7,"remanded_pct":54.2,"granted_on_merits_pct":74,"by_year":[{"year":2017,"issues":108,"granted_pct":12,"denied_pct":26.9,"remanded_pct":57.4},{"year":2018,"issues":292,"granted_pct":28.4,"denied_pct":13.7,"remanded_pct":56.8},{"year":2019,"issues":495,"granted_pct":28.5,"denied_pct":11.5,"remanded_pct":59.4},{"year":2020,"issues":517,"granted_pct":29.4,"denied_pct":14.3,"remanded_pct":55.9},{"year":2021,"issues":552,"granted_pct":22.5,"denied_pct":18.1,"remanded_pct":58.9},{"year":2022,"issues":541,"granted_pct":23.5,"denied_pct":12,"remanded_pct":64},{"year":2023,"issues":672,"granted_pct":30.7,"denied_pct":9.1,"remanded_pct":59.8},{"year":2024,"issues":949,"granted_pct":35.6,"denied_pct":10.2,"remanded_pct":53.5},{"year":2025,"issues":1088,"granted_pct":47.2,"denied_pct":8.2,"remanded_pct":43.8},{"year":2026,"issues":363,"granted_pct":44.4,"denied_pct":11.6,"remanded_pct":43.3}],"benefit_of_doubt_in_grants_pct":74.7,"evidence_on_merits":[{"evidence":"va_exam_favorable","decisions_with":604,"granted_pct_with":86.3,"granted_pct_without":71.5},{"evidence":"va_exam_unfavorable","decisions_with":4453,"granted_pct_with":71.6,"granted_pct_without":85.6},{"evidence":"nexus_positive","decisions_with":2082,"granted_pct_with":94.1,"granted_pct_without":37.6},{"evidence":"nexus_negative","decisions_with":3780,"granted_pct_with":70.6,"granted_pct_without":83.3},{"evidence":"private_opinion","decisions_with":2865,"granted_pct_with":85.9,"granted_pct_without":43.1},{"evidence":"treating_physician","decisions_with":254,"granted_pct_with":78.1,"granted_pct_without":73.7},{"evidence":"lay_statement","decisions_with":4018,"granted_pct_with":67.9,"granted_pct_without":91.5},{"evidence":"buddy_statement","decisions_with":277,"granted_pct_with":77.2,"granted_pct_without":73.8},{"evidence":"combat_service","decisions_with":241,"granted_pct_with":72.8,"granted_pct_without":74}],"top_reasons":{"granted":[{"reason":"caused by the service-connected disability","decisions":264},{"reason":"current diagnosis established","decisions":238},{"reason":"service connection established","decisions":172},{"reason":"aggravated by the service-connected disability","decisions":113},{"reason":"va examiner: less likely than not related to service","decisions":44},{"reason":"service records negative or silent","decisions":20}],"denied":[{"reason":"va examiner: less likely than not related to service","decisions":147},{"reason":"no in-service complaints, treatment or diagnosis","decisions":116},{"reason":"service records negative or silent","decisions":96},{"reason":"preponderance of the evidence against the claim","decisions":63},{"reason":"no current diagnosis","decisions":27},{"reason":"current diagnosis established","decisions":26}]},"recent_examples":{"granted":[{"case_id":"A26040792","year":2026,"judge":"RAY BARTO SLABBEKORN, JR.","rationale":"Current diagnosis of sleep apnea established.; Private physician opinion found at least as likely as not that sleep apnea was directly attributable to long-term consequences of service-connected PTSD and related conditions.; No contrary medical opinion of record."},{"case_id":"A26040879","year":2026,"judge":"JONATHAN HAGER","rationale":"Current disability (OSA) demonstrated; Service connection for PTSD with persistent depressive disorder and insomnia established; Private medical opinion linked OSA to PTSD based on literature and PTSD symptomology; Private opinion found OSA at least as likely as not due to PTSD; No conflicting medic… [truncated, 20 chars omitted]"},{"case_id":"A26040092","year":2026,"judge":"MICHAEL MARTIN","rationale":"Private medical opinion linked OSA to MDD; OSA is but-for caused by MDD; Resolving doubt in favor of veteran"}],"denied":[{"case_id":"A26040923","year":2026,"judge":"B.T. KNOPE","rationale":"Service treatment records did not reflect complaints related to sleep apnea.; VA examiner opined condition was less likely than not proximately due to or the result of acquired psychiatric disorder.; Private opinion lacked specifics and was deemed speculative by the Board."},{"case_id":"A26040502","year":2026,"judge":"MICHAEL A. PAPPAS","rationale":"Insufficient evidence of current diagnosis of sleep apnea.; VA sleep study negative for obstructive sleep apnea.; Examiner found no current signs or symptoms attributable to sleep apnea."},{"case_id":"A26039213","year":2026,"judge":"BETHANY L. BUCK","rationale":"No current diagnosis of sleep apnea established.; Veteran failed to attend scheduled sleep study.; Private medical opinion insufficient without objective testing."}]},"how_argued":{"note":"From keyword matches in each issue's AI summary and rationale, not the full decision. Only issues whose text names a medical link are counted under pathways; one issue can name several. A link named in a denial was often the argument the Board rejected.","issues":5577,"aggravation_discussed":{"issues":2539,"granted_pct":29.7},"causation_only":{"issues":3038,"granted_pct":36.3},"issues_naming_a_pathway_pct":40.3,"pathways":[{"pathway":"Weight gain or obesity","issues":1658,"granted_pct":41.6,"examples":[{"case_id":"26001663","year":2026,"outcome":"GRANTED","quote":"Obesity considered as an intermediate step, with the Board finding the evidence in equipoise regarding its link to service-connected conditions and sleep apnea."},{"case_id":"26000381","year":2026,"outcome":"DENIED","quote":"Examiners cited obesity and macroglossia as primary causes of OSA, with no pathophysiological link to depression.."}]},{"pathway":"Sleep disruption","issues":583,"granted_pct":25.7,"examples":[{"case_id":"26003457","year":2026,"outcome":"GRANTED","quote":"In-service complaints of trouble sleeping and fatigue, and reports of snoring, support second element."},{"case_id":"26000916","year":2026,"outcome":"DENIED","quote":"In-service complaints of nightmares and insomnia"}]},{"pathway":"Nerve involvement","issues":79,"granted_pct":51.9,"examples":[{"case_id":"A26002032","year":2026,"outcome":"GRANTED","quote":"Service connection for Obstructive Sleep Apnea (OSA) was granted as secondary to the Veteran's service-connected persistent depressive disorder with anxious distress, left ulnar nerve neuropathy, and lumbosacral strain, with obesity as..."},{"case_id":"25004096","year":2025,"outcome":"DENIED","quote":"The veteran sought service connection for obstructive sleep apnea, claiming it was secondary to his service-connected diabetes mellitus, ischemic heart disease, unspecified anxiety disorder, and related medications, or peripheral..."}]},{"pathway":"Chronic pain","issues":68,"granted_pct":61.8,"examples":[{"case_id":"A25004703","year":2025,"outcome":"GRANTED","quote":"Service-connected depressive disorder due to chronic pain associated with degenerative arthritis of the lumbar spine."},{"case_id":"A24034355","year":2024,"outcome":"DENIED","quote":"VA examiner found OSA less likely than not caused by obesity, depression, or chronic pain."}]},{"pathway":"Stress","issues":68,"granted_pct":44.1,"examples":[{"case_id":"26003457","year":2026,"outcome":"GRANTED","quote":"in July 2025 found it at least as likely as not related to service, providing a cogent rationale linking in-service sleep issues and operational stressors to the diagnosis."},{"case_id":"23001273","year":2023,"outcome":"DENIED","quote":"The Board found the Veteran's lay statements regarding the alleged stressor to be not credible, and therefore, the claim for secondary service connection could not be established."}]},{"pathway":"Medication side effects","issues":66,"granted_pct":40.9,"examples":[{"case_id":"A26022156","year":2026,"outcome":"GRANTED","quote":"Link to service-connected disabilities (RSD, opioid use)"},{"case_id":"A25051926","year":2025,"outcome":"DENIED","quote":"Service connection for obstructive sleep apnea is denied as secondary to the veteran's acquired psychiatric disorder or opioid usage."}]},{"pathway":"Reduced activity or mobility","issues":61,"granted_pct":62.3,"examples":[{"case_id":"A26010544","year":2026,"outcome":"GRANTED","quote":"VA opinions found OSA not related to service, attributing it to diet, genetics, and sedentary lifestyle."},{"case_id":"A24034355","year":2024,"outcome":"DENIED","quote":"Medical evidence does not support that inability to exercise due to service-connected disabilities caused obesity.."}]},{"pathway":"Altered gait or overuse","issues":18,"granted_pct":55.6,"examples":[{"case_id":"A25028203","year":2025,"outcome":"GRANTED","quote":"Greater weight of adequate and probative evidence favored the veteran's claim for secondary service connection.."},{"case_id":"A25100748","year":2025,"outcome":"DENIED","quote":"Symptoms of sleep impairment compensated within generalized anxiety disorder rating."}]}]},"how_va_rates":{"citation":"38 CFR 4.97","diagnostic_code":"6847","name":"Sleep Apnea Syndromes (Obstructive, Central, Mixed)","url":"https://www.ecfr.gov/current/title-38/section-4.97","levels":[{"criteria":"Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requires tracheostomy","rating":100},{"criteria":"Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine","rating":50},{"criteria":"Persistent day-time hypersomnolence","rating":30},{"criteria":"Asymptomatic but with documented sleep disorder breathing","rating":0}],"notes":[]},"requirements":"38 CFR 3.310: a current diagnosis, a service-connected disability, and medical evidence that it caused (3.310(a)) or aggravated (3.310(b)) the condition."}}