SLEEP APNEA SYNDROMES (OBSTRUCTIVE CENTRAL MIXED)

Summary

The Veteran, who served from April 1985 to November 1994, September 1998 to June 1999, and September 2004 to September 2008, appeals the denial of service connection for obstructive sleep apnea. The Veteran claims symptoms began during his final period of active duty at Fort Leonard Wood from September 2004 to September 2008, reporting excessive daytime tiredness, shortness of breath, and loud snoring. His wife corroborated these symptoms, noting a change in his sleeping patterns during leave from service. The Veteran's Service Treatment Records (STRs) noted complaints of shortness of breath in a pre-deployment health assessment, and he was found not deployable due to this. Following separation in September 2008, the Veteran sought VA care, where sleep apnea was suspected and later diagnosed in late 2008 and early 2009 through VA sleep studies. The Board found the Veteran competent and credible in reporting the onset of his symptoms, noting the short timeframe between separation and diagnosis, the STR findings, and the corroborating lay evidence. Consequently, the Board found the obstructive sleep apnea to be etiologically related to active service and granted service connection.

Rationale

Current diagnosis of obstructive sleep apnea; Competent and credible lay statements regarding onset of symptoms; STRs noted shortness of breath; Etiologically related to active service

Full Decision Text

Citation Nr: A26040895
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 250521-546911
DATE: April 30, 2026

ORDER

Entitlement to service connection for obstructive sleep apnea is granted.

FINDING OF FACT

The Veteran's obstructive sleep apnea is etiologically related to his active service. 

CONCLUSION OF LAW

The criteria for entitlement to service connection for obstructive sleep apnea have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from April 1985 to November 1994, September 1998 to June 1999, and September 2004 to September 2008.  

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2025 Appeals Modernization Act (AMA) rating decision by the Agency of Original Jurisdiction (AOJ) that considered the evidence of record on that date.  In May 2025, the Veteran submitted a VA Form 10182 electing Direct Review as the review option.

Based on the Veteran's election, the Board may only consider the evidence of record at the time of the April 2025 rating decision. 38 C.F.R. § 20.301.  Any additional evidence associated with the claims file during a period of time when additional evidence was not allowed has not been considered. 

Despite the favorable decision herein, if the Veteran would like VA to consider any evidence that was added to the claims file that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

The Board notes that less than one year has elapsed since April 30, 2025, the mailing of notice of the April 2025 rating decision on appeal.  Generally, the Board may not decide an appeal prior to the expiration of the one-year period.  Williams v. McDonough, 37 Vet. App. 305 (2024).  However, as the Board herein grants the benefit sought on appeal in full, there is no prejudice to the Veteran in proceeding.  

Entitlement to service connection for obstructive sleep apnea is granted. 

Service connection means that a veteran has a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge when the evidence shows that the disease was incurred in service. 38 C.F.R. § 3.303(d).

Entitlement to service connection is established when the following elements are satisfied: (1) the existence of a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship or "medical nexus" between the current disability and the disease or injury incurred or aggravated during service. Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); see 38 C.F.R. § 3.303(a).

In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on the onset and continuity of his current symptomatology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge). Lay evidence can also be competent and sufficient evidence of a diagnosis or to establish etiology if (1) the layperson is competent to identify the medical condition; (2) the layperson is reporting a contemporaneous medical diagnosis; or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). When considering whether lay evidence
) (a Veteran is competent to report on that of which he or she has personal knowledge). Lay evidence can also be competent and sufficient evidence of a diagnosis or to establish etiology if (1) the layperson is competent to identify the medical condition; (2) the layperson is reporting a contemporaneous medical diagnosis; or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). When considering whether lay evidence is competent the Board must determine, on a case by case basis, whether the Veteran's particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau, 492 F.3d at 1376-77.

A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence. See 38 U.S.C. § 5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). If "the positive and negative evidence is in approximate balance (which includes but is not limited to equipoise) the claimant receives the benefit of the doubt." Id.

The Veteran maintains that he suffers from obstructive sleep apnea that is related to active service. See October 2024 Correspondence. In particular, he reported that he began feeling symptoms of sleep apnea, to include shortness of breath, excessive daytime tiredness, and loud snoring during his last period of active duty at Fort Leonard Wood from September 2004 to September 2008. See August 2023 Lay Statement. The AOJ has found that the Veteran has a current diagnosis of obstructive sleep apnea. See VA Rating Decision, dated April 28, 2025. The Board is bound by this favorable finding. 38 C.F.R. § 3.104(c). 

As noted above, the Veteran reported that he began feeling symptoms of sleep apnea during his final period of active duty at Fort Leonard Wood from September 2004 to September 2008. See August 2023 Lay Statement. He stated that he routinely felt tired and rundown, and that he felt like he could lay down and take a nap at any time while he was on duty. He reported that during a visit home during a period of leave, his wife complained that he was snoring loudly and appeared to cease breathing during his sleep, after which she shook him awake. The Veteran's wife submitted a statement on his behalf, confirming that she first noticed a change in his sleeping patterns when he visited home from active duty on a period of leave. See October 2024 Lay Statement. She reported that prior to this period of deployment, she never witnessed snoring or breathing issues during his sleep. When he visited her on a period of leave during his last deployment, she noticed loud snoring and tossing and turning in his sleep. She reported that he took long naps during the day and would often complain about being tired. In a February 2007 pre-deployment health assessment, the Veteran was found not deployable, in part due to a history of shortness of breath. The Veteran was released from active duty on September 3, 2008. 

The Board finds the Veteran competent to report on the details of the onset of his obstructive sleep apnea. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). The Board also finds the Veteran's statements to be credible. As the Veteran has a current diagnosis of obstructive sleep apnea, and as his lay statements regarding the onset of his disability and symptoms are credible and corroborated by his Service Treatment Records (STRs), the first two elements of service connection have been met.

The Veteran established care with the VA in November 2008, 2 months after he separated from service. At his first primary care visit, he reported that he suffered from significant shortness of breath and that his wife stated that he snored and that she shook him in his sleep to get him to breathe. See November 2008 CAPRI Medical Treatment Record. The VA treatment provider notated "sleep apnea suspected" and referred the Veteran to the sleep lab. A December 2008 VA treatment record reflects that the Veteran was at high risk for obstructive sleep apnea. After a series of cancellations and rescheduling, the Veteran underwent a sleep study and was assessed with sleep apnea. See September 2009, October 2009 CAPRI Medical Treatment Records
 in November 2008, 2 months after he separated from service. At his first primary care visit, he reported that he suffered from significant shortness of breath and that his wife stated that he snored and that she shook him in his sleep to get him to breathe. See November 2008 CAPRI Medical Treatment Record. The VA treatment provider notated "sleep apnea suspected" and referred the Veteran to the sleep lab. A December 2008 VA treatment record reflects that the Veteran was at high risk for obstructive sleep apnea. After a series of cancellations and rescheduling, the Veteran underwent a sleep study and was assessed with sleep apnea. See September 2009, October 2009 CAPRI Medical Treatment Records. He underwent an additional sleep study in January 2010 and was diagnosed with obstructive sleep apnea. He was given a CPAP machine. 

Given the short period of time between the Veteran's treatment and eventual formal diagnosis of obstructive sleep apnea beginning in November 2008 and his separation from active duty in September 2008, his STR's reflecting complaints of shortness of breath, and his competent and credible lay statements regarding the onset of his condition, the Board finds that the Veteran's obstructive sleep apnea is etiologically related to active service. Accordingly, the Board finds that service connection is warranted.

 

 

P.M. DILORENZO

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Mohammad, Tahmina

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.