What Conditions Are Secondary to Sleep Apnea? | Guide

Sleep apnea can lead to various secondary conditions like high blood pressure, heart disease, diabetes, and weight gain. Discover what conditions are secondary to sleep apnea.

Sleep apnea disrupts your breathing at night and is quite common.1 It may cause other health problems. These include high blood pressure, heart disease, diabetes, and gaining weight. If you are a veteran, knowing these connections is key. It helps you claim VA disability benefits. By understanding these links, you can get the help you need.

Key Takeaways

  • Sleep apnea can lead to various secondary health conditions.
  • It’s important for veterans to know these links when applying for VA benefits.
  • Other conditions like asthma, GERD, PTSD, and mental health problems can be linked to sleep apnea.
  • If your sleep apnea is due to your service, you might get benefits for these related issues.
  • Having a VA disability lawyer on your side can make sure you get all the benefits for your health issues.

Understanding Sleep Apnea

Sleep apnea is a problem that makes it hard to breathe while sleeping.2 It has three types: obstructive, central, and a mix called complex.

Types of Sleep Apnea

Obstructive sleep apnea (OSA) happens when the throat’s muscles get soft and block the airway.2 Central sleep apnea is when the brain doesn’t tell the body to breathe right. Complex sleep apnea is a mix of both.2

Symptoms of Sleep Apnea

Loud snoring, gasping for air, and a dry mouth when waking up are signs.2 So are headaches, and feeling very tired during the day.2 People may also make snorting or gasping noises often while asleep.2

Diagnosing and Treating Sleep Apnea

A sleep study is needed to confirm if you have sleep apnea for VA disability.2 Ways to treat it include losing weight if you need to, stopping smoking, or using a CPAP machine.2

Service Connection for Sleep Apnea

To get primary service connection for sleep apnea, a veteran must give the VA three key things. They need a current sleep apnea diagnosis from a sleep study. They must show an event, illness, or injury from their time in service. And it must be clear that the sleep apnea is linked to that event.1

If vets already have their sleep apnea service-connected, they can tie other conditions to it for secondary service connection.1 This includes issues like asthma, GERD, and more. The process for this is similar to the first connection claim.

Primary Service Connection Requirements

Vets wanting primary connection must prove they have sleep apnea now. They also need to link an in-service event, injury, or illness to their apnea. And a doctor must say the apnea is from that time in the service.1

Secondary Service Connection for Sleep Apnea

Vets with service-connected sleep apnea can get other issues tied to it for secondary service connection.1 This might include things like asthma or PTSD. Conditions that sleep apnea causes or makes worse.

To make this link, vets need to show they have the secondary condition now. A doctor has to say it comes from the service-connected sleep apnea. And they have to prove the event, injury, or illness in their service that caused the sleep apnea.1

Compensation and Pension Exams

Veterans might need a C&P exam after filing a claim for a secondary service connection. This is for conditions related to sleep apnea, which is already service-connected.3 The exam checks the cause and seriousness of the veteran’s issue, linking it to the primary service-connected condition. In this case, it’s sleep apnea.3 The examiner will look at the veteran’s records closely. They may check both the main disability and the new one.3 Going to this exam is key. Not showing up or not cooperating can mean the claim might not be approved.

Having a C&P exam for sleep apnea is a big step. It helps connect other health problems to sleep apnea.3 The VA needs this to figure out the right disability rating for the veteran.1 Veterans suffering from sleep apnea often get diagnosed with other conditions. These might include asthma, GERD, and mental health issues.1

At the exam, the examiner will look through the veteran’s health history and do a check-up. They will see how bad the sleep apnea and other conditions are.3 They might also ask for more tests or to see more medical records. This gives a full picture of the veteran’s health.3 It’s very important for veterans to show up and tell everything truthfully. They must work with the examiner to push their claim through.3

C&P exams for sleep apnea

The C&P exam for sleep apnea is vital during the VA disability process.3 Knowing why this exam matters helps veterans get ready for it. They can make sure they get the benefits they deserve for their service.3

What Conditions Are Secondary to Sleep Apnea?

Sleep apnea can lead to or make many health conditions worse. This includes asthma1, GERD14, and more. If you’re a veteran with sleep apnea, you might get help for these extra health issues.

Asthma can get worse with sleep apnea. Veterans might find sleep apnea leading to or worsening GERD14. Both these conditions can affect each other.

If you’re a veteran, having sleep apnea can also mean getting help for hypothyroidism1. Veterans could link hypothyroidism to their sleep apnea.

Sleep apnea is risky for veterans with PTSD. The worse your PTSD, the worse your sleep apnea could get14.

Veterans may also connect anxiety and depression to sleep apnea1. Sleep apnea could make these mental health issues worse.

Chronic sinusitis could be due to military burn pit exposure1. Sleep apnea might also link to sinusitis for some veterans1.

There’s a link between sleep apnea and tinnitus. Veterans with sleep apnea might get tinnitus support too.

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Obesity, substance abuse, and more can worsen with sleep apnea4. Veterans could get help for these if they have sleep apnea4.

Many other conditions, like heart disease and migraines, might be related to sleep apnea4. Veterans could get support for these conditions if they have sleep apnea.

Asthma Secondary to Sleep Apnea

Asthma makes it hard to breathe. You may feel like your chest is tight. Or hear a whistling sound when you breathe out. Trouble sleeping is also common.5 The CDC says about 8% of Americans, or 25 million, have asthma.5

Studies show asthma and sleep apnea often go together. This is because they both affect how we breathe. Weak throat muscles from asthma can cause the airway to block off more easily.

Asthma Symptoms

If you have asthma, you might feel short of breath. Your chest might feel tight or hurt. Sleeping can be tough. You might notice a whistling sound when you breathe out.5 About half of adults with asthma also have sleep apnea.5 And, nearly 28% of people with asthma are at risk for sleep breathing problems.5

Link Between Asthma and Sleep Apnea

People with asthma might develop sleep apnea more often.6 This happens because both conditions affect our airways. With asthma, the throat muscles might be weak. This makes the airway more likely to close up.

A study showed 27% of asthma patients got sleep apnea after four years.5

GERD Secondary to Sleep Apnea

Gastroesophageal Reflux Disease (GERD) is a big name for stomach acid going the wrong way. It travels back up from the stomach to the esophagus, hurting it and causing inflammation. GERD shows up with feelings like nausea, throw-up, heartburn, hard breathing, and chest pain.1 For veterans with sleep apnea, GERD may become worse or begin because of their sleep condition.1 When asleep, the body doesn’t clear the esophagus as well as it does when awake. This can make GERD symptoms worse in the mornings for veterans.7 Also, GERD might help cause sleep apnea. This happens because the acid can make the vocal cords tighten, which can lead to sleep apnea.7

GERD Symptoms

Symptoms of GERD are not fun and include feeling sick, throwing up, heartburn, trouble breathing, and chest pain.8 The link between GERD and sleep apnea is important, with over half of sleep apnea folks also getting GERD.7

Bidirectional Relationship with Sleep Apnea

1 Studies show sleep apnea and GERD might have a deep connection.8 From over 22 million GERD patients, about 12% also had sleep apnea. That’s higher than those without GERD.7 Being overweight is a shared risk for both sleep apnea and GERD. This can make both conditions worse.7 Drinking alcohol and taking certain drugs might up your risk for these conditions too.7

1 Veterans with sleep apnea might see GERD symptoms get worse or start because of their sleep condition.8 A mix of GERD and sleep apnea often happens more in females, Caucasians, those in the south, heavy folks, those with type 2 diabetes, and smokers.8 Obesity is way more common in people with both GERD and sleep apnea compared to just GERD alone.8

Hypothyroidism Secondary to Sleep Apnea

Hypothyroidism Symptoms

When the thyroid gland doesn’t make enough hormone, it’s called hypothyroidism. People with this condition often feel tired, gain weight, and are cold a lot. They may also have a puffy face, constipation, and dry skin. Hair loss, irregular periods, feeling sad, and a slow heartbeat are common too.9 Hypothyroidism can change the upper airway, making sleep apnea worse or causing it.9 Veterans can connect their sleep apnea to hypothyroidism for benefits.

Studies have found a strong connection between sleep apnea and hypothyroidism.9 Even in the US, 7.3% of adults with sleep apnea also have hypothyroidism.9 In obese people, up to 29.3% with breathing problems at night have hypothyroidism.9 So, it’s crucial to check thyroid health for veterans with sleep apnea.

Since sleep apnea and hypothyroidism are closely linked, veterans with sleep apnea may get benefits for hypothyroidism too. This ensures they get the right help and benefits for their conditions.

PTSD Secondary to Sleep Apnea

PTSD is a mental health issue after trauma. Signs include memories, nightmares, avoiding reminders, and not sleeping well.10

PTSD Symptoms

Veterans might have rough symptoms like bad memories, avoiding the past, nightmares, and struggles with sleep.10

Sleep Apnea and PTSD Link

Veterans with PTSD might get sleep apnea. PTSD’s severity links with sleep apnea’s severity. Both PTSD and sleep apnea’s symptoms can get worse from similar things. These include not sleeping well, staying alert, and feeling tired during the day.1110

In April 2020, a private psychologist thought a Veteran’s sleep apnea came from her PTSD. They pointed to studies on anxiety, PTSD, and sleep apnea.11 In August 2020, a private psychiatrist said the Veteran’s sleep apnea was due to bad sleep from PTSD. Obesity was also a factor.11 So, the Board agreed. They saw the psychologist’s and psychiatrist’s opinions as proof the Veteran’s sleep apnea was largely due to her PTSD.11

Mental Health Conditions Secondary to Sleep Apnea

Sleep apnea can lead to other issues like anxiety and depression.12 Many people with sleep apnea also have anxiety (17%) and depression (22%). For PTSD, the number is 11%.12 Anxiety and depression can make it hard to sleep well. They can also make people feel too alert or watchful all the time.12

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This is especially true for veterans with these problems. If a veteran is already getting help for anxiety or depression, they might also get help for sleep apnea. The same is done the other way around too.

12 Sleep apnea can make mental health issues like anxiety and depression worse.12 Stress from PTSD and anxiety can mess up sleep even more. This makes sleep apnea symptoms worse too.12 Problems like depression can change how we sleep. This might lower REM sleep, making sleep apnea events more likely.

Getting help for mental health connected to sleep apnea is possible. It shows how important it is to understand these connections for benefits Kept.

13 About 3.3% of people from 2008 to 2014 said they had sleep apnea in the past year.13 Those with sleep apnea were more likely to feel depressed, think about suicide, and worry a lot.13 They also felt they needed but did not receive enough mental health care, despite getting some help.

13 In the US, 13% of men and 6% of women might have sleep apnea.13 Some get help for their mental health with sleep apnea, but not everyone does. So, how people use mental health services with sleep apnea is mixed.

Sinusitis Secondary to Sleep Apnea

Sinusitis means your sinuses are swollen and hurt for over three months.14 People with sleep apnea have a higher chance of getting chronic sinusitis.14 This also makes sleep apnea worse.14 If you were exposed to military burn pits, you might have a greater chance of getting sinusitis.15 This is especially true for veterans in certain locations and times.15

Sinusitis Symptoms

You might notice your nose is sore, and you have thick or colored mucus if you have sinusitis.14 Maybe you find it hard to breathe or feel pain around your eyes or nose.14 Also, you might not be able to smell or taste things well. Other signs could include ear pain and feeling very tired.14

Sinusitis and Sleep Apnea Connection

Sinusitis and sleep apnea both affect how your nose, throat, and head feel.14 Veterans might get help for sinusitis related to sleep apnea if they can prove it.15 Lots of veterans face sinusitis because of their military service, which could lead to sleep apnea later.16

For the VA to help, veterans must show a doctor agrees their sleep apnea is due to their sinusitis.16 A Nexus Letter that links both conditions can help you get VA benefits.16

The VA decides how to rate your sleep apnea based on how bad it is.16 Most veterans with sleep apnea from sinusitis get a 50% rating.16 Those with a 50% rating or more might need a CPAP or similar device to help them breathe better.16

Tinnitus Secondary to Sleep Apnea

Tinnitus causes noise or ringing in the ears. It’s a top reason why people seek VA help.17 This issue affects 15% to 20% of everyone, more commonly as we get older or if you’re a Veteran.17 Shockingly, 80% of soldiers with tinnitus also face sleep apnea.17 Tinnitus usually links to other problems, like hearing loss or injuries. Those with tinnitus might hear sounds like ringing or buzzing.

Tinnitus Symptoms

Tinnitus is tied to sleep apnea, especially in Veterans. If a Veteran has service-linked sleep apnea, they might also get help for tinnitus.18 The proof says sleep apnea for Veterans comes from their tinnitus.18 And so, they get help for sleep apnea because of their tinnitus.

what conditions are secondary to sleep apnea

Obesity is a big risk for sleep apnea. It makes people tired and less likely to exercise. This in turn can cause obesity.14 Substance abuse like drinking or using drugs affects sleep. Sleep systems in the brain get disrupted, leading to bad sleep.

Sleep Apnea and Obesity

Sleep apnea and being overweight are connected. Sleep apnea can make you gain weight. This is because it messes up your sleep and makes you tired during the day. You end up moving less and eating more.14 On the other hand, being too heavy is a big reason for sleep apnea. Extra weight puts pressure on the airway. This can make it close up when you sleep.14

Sleep Apnea and Substance Abuse

Using alcohol, opioids, or other drugs can also cause sleep apnea. These things mess with your sleep and the way your brain controls your breathing. This might bring on or make sleep apnea worse.14 Veterans who have used drugs or alcohol and have sleep apnea should be checked for it.

Other Conditions Related to Sleep Apnea

Aside from obesity and drug use, sleep apnea can lead to other problems. These include asthma, gastroesophageal reflux disease (GERD), heart disease, migraines, and strokes. If a veteran has sleep apnea and these issues, they might get help.14 This is if they can show a clear link between them and their sleep apnea.

TDIU for Sleep Apnea

Many veterans with sleep apnea might get TDIU benefits.19 TDIU helps those with disabilities. If they can’t work because of their health, they may get 100% pay. This also includes veterans with sleep apnea. Sometimes, their other health issues are because of their time in the military. These problems can make working hard.19 So, if these health issues stop a veteran from getting a job, they could get extra help.19

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VA Rating for Sleep ApneaMonthly Compensation
100% (Chronic respiratory failure, carbon dioxide retention, tracheostomy need, or cor pulmonale)$3,737.854
50% (Use of CPAP machine or other breathing device)$1,075.164
30% (Persistent daytime sleepiness)$524.314
0% (Asymptomatic, but with established service connection)Non-compensable19

Veterans might get TDIU benefits if their sleep apnea symptoms affect work.19 To qualify, veterans need a 70% combined disability rating. One disability must be at least 40%.19 They also need to prove they can’t hold a job because of their health.19

Get Help with Your Sleep Apnea Claim

Navigating the VA disability claims process can be tough. If you’re a veteran with sleep apnea and need help, think about getting a VA disability lawyer or a claims agent.1 These experts know how to get the right medical proof, fill out claims, and fight for you if your claim is turned down. They make sure you get all the disability benefits you should.


Sleep apnea affects many veterans and is linked to other health issues. It’s key for them to connect these problems to their time in service to get more benefits.11 Having a skilled VA disability lawyer can make sure veterans get all the help they should, for sleep apnea and other health troubles.

OSA is common worldwide, hitting about 1 billion people. In adults aged 30 to 69, around 425 million have it bad.20 In the US, 25% to 30% of men and 9% to 17% of women face OSA.20 Since more people are becoming obese, OSA rates are climbing too.20 So it’s vital for veterans to link their sleep apnea to other issues. This step ensures they get all the money they’re owed.

Veterans can get help with their disability claims and get the right benefits with an expert on their side.11 This method can greatly improve a veteran’s situation. It helps them get the money and care needed to stay healthy.


What are the main types of sleep apnea?

There are three main types of sleep apnea. These are obstructive, central, and complex (mixed) sleep apnea.

What are the common symptoms of sleep apnea?

Symptoms include loud snoring, gasping for air at night, waking with a dry mouth, and morning headaches. Also, people with sleep apnea feel very tired during the day.

How is sleep apnea diagnosed for VA disability claims?

A sleep study is needed to confirm sleep apnea for VA disability compensation.

What are the requirements for primary service connection for sleep apnea?

For primary service connection, a veteran must have a current sleep apnea diagnosis. Part of this is showing an in-service event. They must also link this to their sleep apnea.

Can veterans receive secondary service connection for conditions related to their sleep apnea?

Yes, veterans can get secondary service connection. This is for health issues caused or made worse by their service-connected sleep apnea.

What is the purpose of a Compensation and Pension (C&P) exam for secondary service connection claims?

The C&P exam looks at a veteran’s condition. It checks how it’s linked to their service-connected disability. In this case, it’s sleep apnea.

What common conditions can be secondary to sleep apnea?

Conditions like asthma, GERD, hypothyroidism, and PTSD can be linked to sleep apnea. So can anxiety, depression, sinusitis, and tinnitus.

How can sleep apnea be linked to asthma?

Asthma and sleep apnea can affect similar parts of the body. Throat muscles weakened by asthma can make the throat collapse. This blocks the airway.

What is the relationship between sleep apnea and GERD?

Sleep apnea can make GERD worse by interfering with the body’s natural clearing process. GERD can also cause sleep apnea by irritating the throat.

How can sleep apnea be linked to hypothyroidism?

Hypothyroidism may change the upper airway. This can lead to or worsen sleep apnea. Veterans can get secondary service connection for this related to sleep apnea.

What is the connection between sleep apnea and PTSD?

Veterans with PTSD can be at a higher risk for sleep apnea. Severe PTSD can make sleep apnea worse. This is because some factors that affect PTSD also affect sleep apnea.

Can other mental health conditions be linked to sleep apnea?

Yes, sleep apnea can be linked to conditions like anxiety and depression. They can mess with sleep and cause hyperarousal or hypervigilance.

How can sinusitis be connected to sleep apnea?

Chronic sinusitis affects the same areas as sleep apnea. So, veterans can get a link to their sleep apnea for this condition.

Can tinnitus be secondary to sleep apnea?

Yes, tinnitus is linked to sleep apnea. Veterans with sleep apnea might get tinnitus as a secondary service connection.

What other conditions can be related to sleep apnea?

Sleep apnea can cause or worsen asthma, GERD, heart disease, migraines, and strokes.

Can sleep apnea lead to TDIU benefits?

A VA sleep apnea rating can help veterans get TDIU benefits. This is because sleep apnea and related conditions can make working hard.

How can a VA disability lawyer help with sleep apnea claims?

A VA disability lawyer can assist in getting the right medical evidence. They help file claims and support in the appeals process. This ensures veterans get their full disability benefits.

Source Links

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  2. https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631
  3. https://www.benefits.va.gov/compensation/docs/Sleep_Apnea.pdf
  4. https://www.woodslawyers.com/va-sleep-apnea-rating/
  5. https://www.woodslawyers.com/secondary-conditions-to-asthma-sleep-apnea/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946549/
  7. https://www.woodslawyers.com/sleep-apnea-secondary-gerd-veterans/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980249/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8423342/
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410924/
  11. https://www.va.gov/vetapp21/Files11/A21018009.txt
  12. https://www.hillandponton.com/obstructive-sleep-apnea-mental-illness/
  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5560422/
  14. https://veteranshelpgroup.com/conditions-linked-to-sleep-apnea/
  15. https://cck-law.com/blog/va-disability-for-sleep-apnea-secondary-to-sinusitis/
  16. https://telemedicallc.com/blog/nexus-letter-for-sleep-apnea-secondary-to-sinusitis
  17. https://ptsdlawyers.com/va-rating-for-sleep-apnea-secondary-to-tinnitus/
  18. https://www.va.gov/vetapp22/Files10/22057353.txt
  19. https://www.seankendalllaw.net/faqs/getting-tdiu-for-sleep-apnea.cfm
  20. https://www.ncbi.nlm.nih.gov/books/NBK459252/