VA Disability Rating for Sleep Apnea: Complete 2026 Guide

Sleep apnea is one of the most common VA disability claims, and for good reason—it affects thousands of veterans and can significantly impact daily life. This guide explains exactly how VA rates sleep apnea under 38 CFR §4.97, Diagnostic Code 6847, what evidence you need, and strategies to maximize your rating.

Sleep Apnea Rating Criteria

VA rates obstructive sleep apnea (OSA) based on severity and treatment requirements:

Rating	VA Criteria
0%	Asymptomatic but with documented sleep disorder breathing
30%	Persistent daytime hypersomnolence (excessive sleepiness)
50%	Requires use of breathing assistance device such as CPAP machine
100%	Chronic respiratory failure with carbon dioxide retention or cor pulmonale; OR requires tracheostomy

The 50% rating is most common. If you use a CPAP machine prescribed by a doctor, you qualify for 50%. This is the rating most veterans receive for sleep apnea.

How to Prove Service Connection

There are three main paths to service connection for sleep apnea:

1. Direct Service Connection

Diagnosed during service (rare, since sleep studies weren't common).

2. Secondary Service Connection (Most Common)

Sleep apnea caused or aggravated by another service-connected condition:

PTSD — Strong medical research links PTSD to sleep apnea
Weight gain from other service-connected conditions
Medications that cause weight gain
Sinusitis/rhinitis or deviated septum

3. Gulf War / PACT Act Presumptive

Check eligibility if you served in qualifying locations during qualifying periods.

PTSD Secondary Claims: If you have service-connected PTSD and sleep apnea, file sleep apnea as secondary to PTSD. Medical research supports this link, and it's one of the most commonly approved secondary claims.

Evidence Requirements

For Diagnosis (Required)

Sleep study (polysomnography) showing Apnea-Hypopnea Index (AHI) meeting diagnostic criteria
Can be VA or private sleep study
Home sleep tests may be accepted

For 50% Rating

CPAP prescription from a physician
Proof of CPAP use (machine data helps but not required)

For Service Connection

Nexus letter linking sleep apnea to service or another service-connected condition
Buddy letters from roommates/spouse about snoring, witnessed breathing stops

Evidence That Wins

✓Sleep study results showing OSA diagnosis
✓CPAP prescription from physician
✓Nexus letter explaining PTSD connection (well-documented medical link)
✓Lay statements about snoring during service
✓Buddy letters from spouse about witnessed breathing stops
✓Documentation of daytime fatigue and its impact

Evidence That Loses

✗No sleep study to confirm diagnosis
✗Sleep study doesn't meet diagnostic threshold
✗CPAP prescribed but never used
✗No nexus to service or service-connected condition
✗Symptoms started well after service with no connection

Secondary Conditions

If you have service-connected sleep apnea, you may be able to claim these as secondary:

Hypertension — Strong medical link to sleep apnea
Heart conditions
Diabetes (weight-related)
Depression/anxiety
Erectile dysfunction

Always claim hypertension secondary to sleep apnea if you have both. The medical research supporting this connection is very strong, and it can add 10-60% to your combined rating.

Filing Tips

Get a sleep study FIRST — no diagnosis means no claim
Get CPAP prescribed (even if you don't use it regularly)
If secondary to PTSD, get a nexus letter explaining the medical link
Get buddy letters from your spouse about snoring and breathing stops
Document daytime fatigue and how it affects your daily life
Consider claiming hypertension as secondary if applicable

Proposed Rating Changes: VA has proposed changes to sleep apnea ratings in the future. Current ratings are protected if already service-connected, but check current regulations when filing new claims.