Primary service-connected condition

DC 6847 — Sleep Apnea Syndromes

Also known as: cpap, osa, sleep apnea, Sleep Apnea, Sleep Apnea Syndrome, obstructive sleep apnea, snoring, BiPAP, stop breathing, choking in sleep

Mapped secondary conditions
8

These are commonly claimed secondary connections linked to this primary disability. Use them as a screening tool for conversations with your doctor, VSO, or VA-accredited attorney.

Primary Secondary

Sleep Apnea Syndromes Hypertensive vascular disease

7101
Strong

How the connection is commonly explained

Sleep apnea causes repeated oxygen desaturation, directly elevating blood pressure. This is one of the strongest medical links.

Filing tip

Ask your doctor to clearly state that the secondary condition is at least as likely as not caused or aggravated by the primary service-connected condition. For this pairing, ask the provider to explain how sleep apnea syndromes led to or worsened hypertensive vascular disease.

Relationship type: Caused by
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Primary Secondary

Sleep Apnea Syndromes Major depressive disorder

9434
Strong

How the connection is commonly explained

Chronic sleep deprivation from untreated sleep apnea frequently leads to depression.

Filing tip

Ask your doctor to clearly state that the secondary condition is at least as likely as not caused or aggravated by the primary service-connected condition. For this pairing, ask the provider to explain how sleep apnea syndromes led to or worsened major depressive disorder.

Relationship type: Caused by
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Primary Secondary

Sleep Apnea Syndromes Arteriosclerotic heart disease

7005
Moderate

How the connection is commonly explained

Untreated sleep apnea significantly increases risk of ischemic heart disease.

Filing tip

A nexus letter and treatment records explaining the progression from the primary condition to the secondary condition can make a big difference. For this pairing, ask the provider to explain how sleep apnea syndromes led to or worsened arteriosclerotic heart disease.

Relationship type: Caused by
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Primary Secondary

Sleep Apnea Syndromes Hiatal hernia and paraesophageal hernia

7346
Moderate

How the connection is commonly explained

Sleep apnea increases intra-abdominal pressure, worsening acid reflux.

Filing tip

A nexus letter and treatment records explaining the progression from the primary condition to the secondary condition can make a big difference. For this pairing, ask the provider to explain how sleep apnea syndromes led to or worsened hiatal hernia and paraesophageal hernia.

Relationship type: Aggravated by
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Primary Secondary

Sleep Apnea Syndromes Hypertensive heart disease

7007
Moderate

How the connection is commonly explained

Sleep apnea increases risk of atrial fibrillation and cardiac arrhythmias through repeated hypoxia and cardiac stress.

Filing tip

File heart condition as secondary to sleep apnea with cardiology records and sleep study results.

Relationship type: Caused by
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Primary Secondary

Sleep Apnea Syndromes Migraine

8100
Moderate

How the connection is commonly explained

Disrupted sleep and oxygen desaturation trigger migraines.

Filing tip

A nexus letter and treatment records explaining the progression from the primary condition to the secondary condition can make a big difference. For this pairing, ask the provider to explain how sleep apnea syndromes led to or worsened migraine.

Relationship type: Caused by
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Primary Secondary

Sleep Apnea Syndromes Chronic Fatigue

NO-DC-CHRONIC-FATIGUE
Moderate

How the connection is commonly explained

Fragmented sleep prevents restorative rest.

Filing tip

A nexus letter and treatment records explaining the progression from the primary condition to the secondary condition can make a big difference. For this pairing, ask the provider to explain how sleep apnea syndromes led to or worsened chronic fatigue.

Relationship type: Caused by
No standalone condition detail page is available for this mapped item.
No standalone diagnostic code entry exists in the conditions table, so treat this as an informational claim lead and confirm the best code with a VSO or medical provider.
Primary Secondary

Sleep Apnea Syndromes Residuals of traumatic brain injury (TBI)

8045
Emerging

How the connection is commonly explained

Sleep apnea worsens TBI recovery and cognitive symptoms.

Filing tip

Because this connection can be more case-specific, detailed medical rationale and symptom history are especially important. For this pairing, ask the provider to explain how sleep apnea syndromes led to or worsened residuals of traumatic brain injury (tbi).

Relationship type: Aggravated by
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This condition may also be secondary to

Allergic or vasomotor rhinitis
DC 6522
Strong

Nasal obstruction from chronic rhinitis contributes to sleep-disordered breathing

Arteriosclerotic heart disease
DC 7005
Strong

Heart disease and sleep apnea share bidirectional relationship

Asthma, bronchial
DC 6602
Strong

Airway inflammation and respiratory distress overlap with sleep apnea

Posttraumatic stress disorder
DC 9411
Strong

PTSD causes hypervigilance, nightmares, and disrupted sleep patterns that contribute to obstructive sleep apnea. Medications for PTSD can cause weight gain and muscle relaxation.

Septum, nasal, deviation
DC 6502
Strong

Nasal obstruction directly contributes to obstructive sleep apnea

Sinusitis, pansinusitis, chronic
DC 6510
Strong

Chronic nasal congestion and inflammation obstruct airways during sleep

Arm, limitation of motion
DC 5201
Moderate

Shoulder pain disrupts sleep — cannot lie on affected side

Bipolar disorder
DC 9432
Moderate

Bipolar medications (mood stabilizers, antipsychotics) cause weight gain, contributing to sleep apnea.

Degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome (also, see either DC 5003 or 5010)
DC 5242
Moderate

Pain medications can relax the airway and decreased mobility can promote weight gain that worsens sleep apnea.

Degenerative arthritis, other than post-traumatic
DC 5003
Moderate

Reduced mobility leads to weight gain, a primary sleep apnea risk factor

Dermatitis or eczema
DC 7806
Moderate

Itching disrupts sleep

Fibromyalgia
DC 5025
Moderate

Fibromyalgia severely disrupts sleep architecture

Generalized anxiety disorder
DC 9400
Moderate

Anxiety disrupts sleep patterns and may worsen sleep-disordered breathing

Hiatal hernia and paraesophageal hernia
DC 7346
Moderate

GERD and sleep apnea have a bidirectional relationship, and nighttime reflux can worsen breathing problems.

Hypothyroidism
DC 7903
Moderate

Hypothyroidism causes weight gain and tissue swelling that narrows the upper airway, contributing to obstructive sleep apnea.

Intervertebral disc syndrome
DC 5243
Moderate

Opioids, muscle relaxers, and reduced mobility can contribute to sleep apnea.

Lumbosacral or cervical strain
DC 5237
Moderate

Pain medications such as muscle relaxers and opioids can relax airway muscles. Reduced mobility can also contribute to weight gain.

Major depressive disorder
DC 9434
Moderate

Depression-related weight gain and inactivity increase sleep apnea risk

Persistent depressive disorder (dysthymia)
DC 9433
Moderate

Chronic depression causes inactivity, weight gain, and medication side effects that contribute to sleep apnea.

Residuals of traumatic brain injury (TBI)
DC 8045
Moderate

TBI can cause neurological changes that affect breathing during sleep.

Sciatic nerve, paralysis
DC 8520
Moderate

Pain disrupts sleep, medications may worsen sleep apnea

How to File a Secondary Claim

1. Have your primary condition already service-connected.
2. Get diagnosed with the secondary condition.
3. Get a nexus letter from a doctor linking them.
4. File VA Form 21-526EZ and select the claim as a secondary claim.
5. Attend the C&P exam if one is scheduled.

Disclaimer: Secondary connections shown are based on commonly established medical links. Individual claims require medical evidence. Consult a VSO or VA-accredited attorney.