SLEEP APNEA SYNDROMES (OBSTRUCTIVE CENTRAL MIXED)

Summary

The Veteran, an Army Veteran who served on active duty from May 2000 to September 2000 and again from December 2002 to July 2004, appeals the denial of service connection for obstructive sleep apnea. The Veteran testified at a Board hearing in June 2022, reporting persistent sleep issues, fatigue, and memory problems since his deployment in Iraq in 2004. Service treatment records from his deployment, including a June 2004 Post-Deployment Medical Assessment and a September 2005 Post-Deployment Health Assessment, indicated frequent trouble sleeping and feeling tired after sleeping. A May 2025 lay statement from a fellow servicemember, J.M., corroborated the Veteran's complaints, describing witnessed loud snoring, observed breathing pauses during sleep, and frequent complaints of fatigue and morning headaches during their deployment together in Iraq from 2003 to 2004. The Board found J.M.'s statement probative and credible, noting that lay persons are competent to report observable symptoms. While acknowledging prior denials and the mixed nature of previous medical opinions, the Board found the current evidence, including service records and J.M.'s corroborating statement, placed the evidence in approximate balance regarding the onset and persistence of sleep apnea symptoms. Resolving reasonable doubt in the Veteran's favor, the Board found the obstructive sleep apnea was incurred in service and granted service connection.

Rationale

Service treatment records show complaints of sleep problems during deployment.; Fellow servicemember's statement corroborates snoring, breathing pauses, and fatigue.; Evidence found to be in approximate balance, with doubt resolved in Veteran's favor.

Full Decision Text

Citation Nr: 26005125
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 18-14 618
DATE: April 30, 2026

ORDER

Service connection for obstructive sleep apnea is granted.

FINDING OF FACT

The evidence is at least in approximate balance as to whether the Veteran's obstructive sleep apnea first manifested during active duty service, symptoms of which have persisted since service separation.

CONCLUSION OF LAW

Resolving all reasonable doubt in the Veteran's favor, the criteria to establish service connection for obstructive sleep apnea are met.  38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty for training in the U.S. Army from May 2000 to September 2000 and on active duty from December 2002 to July 2004.

This case is before the Board of Veterans' Appeals (Board) on appeal from a March

2016 Department of Veterans Affairs (VA) Regional Office (RO) rating decision. In that rating decision, the RO denied entitlement to service connection for sleep apnea.  Additional evidence was received during the one-year appeal period, and the RO issued another rating decision in October 2016 finding that the evidence received was not new and material, and therefore continued the prior denial of service connection for sleep apnea.  The Veteran appealed that determination in the legacy review system, with a February 2017 notice of disagreement (NOD).  The RO issued a statement of the case (SOC) in January 2018, and the Veteran filed a VA Form 9, substantive appeal to the Board in March 2018.  

In June 2022, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge (VLJ).  A transcript of the testimony is associated with the claims file.

The appeal was remanded by the Board in August 2022.  In a March 2024 decision, the Board denied service connection for sleep apnea.  

The Veteran appealed the Board's March 2024 decision to the United States Court of Appeals for Veterans Claims (Court).  Pursuant to a February 2025 Joint Motion for Remand (JMR) filed by the parties, the Court remanded the issue to the Board for action consistent with the terms of the JMR.  The case has now been returned to the Board for appellate review.

On March 5, 2025, the Veteran was issued a letter notifying him that he had 90 days from the date of the letter to submit any additional argument or evidence, or request a hearing.  In May 2025, the Veteran indicated that he wanted to attend another hearing before the undersigned VLJ.  The Veteran also submitted a lay statement from a fellow servicemember who had served with him during his deployment.  See May 5, 2025 statement from J.M. 

The Veteran has not been afforded his second requested Board hearing.  However, given that this decision represents a full grant of the benefits sought on appeal, there is no prejudice to the Veteran by adjudicating the claim without a second hearing.

Entitlement to service connection for obstructive sleep apnea.

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service.  38 U.S.C.                   § 1110; 38 C.F.R. § 3.303 (a).  Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303(d).

Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability.  Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant.  Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57(1990
 (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability.  Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant.  Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57(1990).  Competency of evidence differs from weight and credibility.  Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted.  Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno v. Brown, 6 Vet. App. 465, 469 (1994).

The Veteran contends that his obstructive sleep apnea is related to his active duty.  During the June 2022 Board hearing, the Veteran testified that halfway through his tour in Iraq he began having sleeping issues, including irregular sleep patterns, being tired in the morning, and not feeling rested after sleeping.  He stated that those problems had persisted since service, and that he had complained over the years about his sleep issues.

The Veteran has been diagnosed with obstructive sleep apnea.  See March 2016 VA examination report (referencing a February 2016 sleep study confirming a diagnosis of obstructive sleep apnea).

Next, service treatment records show complaints of sleep problems during the Veteran's last period of active duty service (i.e., during his deployment in 2004).  For example, a June 2004 Post-Deployment Medical Assessment indicated "YES" as to the Veteran having "frequent trouble sleeping" and "weakness or fatigue."  In a December 2024 Post-Deployment Health Assessment, completed by the Veteran, he specifically indicated that, during his deployment, he had experienced "Still feeling tired after sleeping."

Service records also include a September 2005 Post-Deployment Health Assessment following Hurricane Katrina relief efforts while the Veteran was in the Army National Guard.  At that time, the Veteran again reported "still feeling tired after sleeping." 

Following service separation, the Veteran continued to report sleep-related problems.  During a May 2005 VA psychiatric examination, the Veteran was noted to have difficulty with initiating sleep and maintaining sleep.  In a January 2007 VA psychiatric consult note, the Veteran reported that, since his deployment in Iraq, he was not "sleeping well."  An April 2008 VA treatment record notes that, during service, the Veteran began having memory problems, irritability, headaches, and sleep problems.  In an October 2015 VA treatment note, the Veteran reported that he woke up several times during the night and that his wife had "kicked me out of the bedroom because of my snoring."  

Recently, in May 2025, the Veteran submitted a statement from a fellow servicemember who had served with him in Iraq.  See statement from J.M. dated May 5, 2025.  In this statement, J.M. reports having served with the Veteran for over 6 years, including on deployment to Iraq from 2003 to 2004.  During the deployment, J.M. noted that he was roommates with the Veteran and witnessed loud snoring and observed that the Veteran would "stop breathing for several seconds during sleep, followed by gasping or chocking sounds as he resumed breathing."  J.M. further noted that the Veteran would often complain of fatigue, morning headaches, and difficulty staying awake during the day. 

The Board finds that the statement provided by J.M. is probative and weighs in favor of the claim.  Laypersons are competent to report observable symptoms such as witnessing the Veteran's daytime fatigue and hearing his snoring, breathing pauses, and choking and gasping for breath during his sleep.  See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007); see also Washington v. Nicholson, 21 Vet. App. 191, 195 (2007) (holding that lay persons are competent to provide information regarding visible or otherwise observable symptoms of disability).

The Board recognizes that the previous denial of the claim in the March 2024 decision was based, in large part, on a medical opinion from a June 2023 VA examiner that weighed against the claim
persons are competent to report observable symptoms such as witnessing the Veteran's daytime fatigue and hearing his snoring, breathing pauses, and choking and gasping for breath during his sleep.  See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007); see also Washington v. Nicholson, 21 Vet. App. 191, 195 (2007) (holding that lay persons are competent to provide information regarding visible or otherwise observable symptoms of disability).

The Board recognizes that the previous denial of the claim in the March 2024 decision was based, in large part, on a medical opinion from a June 2023 VA examiner that weighed against the claim.  The Board also found that VA medical opinions obtained in October 2017 and February 2021 lacked probative value as the examiners failed to provide any rationale in support of the opinions rendered and also had based their opinions on misinterpretation of the legal criteria.

Upon further consideration of all the evidence of record, to specifically include service records and corroborating statements from J. M., and a diagnosis of sleep apnea, the Board finds that the evidence is now at least in approximate balance as to whether the Veteran's sleep apnea symptoms first manifested during active duty service and have persisted since that time. 

For these reasons, and resolving reasonable doubt in the Veteran's favor, the Board finds that the Veteran's obstructive sleep apnea was incurred in service.  38 C.F.R. §§ 3.3102, 3.303(d).  The appeal is granted.

 

 

L. B. CRYAN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	R. Casadei, Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.