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Sleep apnea

What it is

Sleep apnea means your breathing stops and starts again and again while you sleep.

VA's code numbers for this: 6847

What the examiner will do

Who does it: A VA doctor or a VA contract examiner. VA's exam page (updated Aug 15, 2025) names four contract companies: Loyal Source Government Services, OptumServe Health Services, Leidos QTC Health Services, and Veterans Evaluation Services (VES). (LHI is an older name; it is now part of OptumServe.) You can't pick which one. Answer every call or letter about scheduling.

  • Usually a VA or contract doctor, nurse practitioner, or physician assistant. Often a short exam, or a review of your records only.
  • They check that a sleep study confirmed it, what treatment you were prescribed, and whether you use it.
  • Questions: Do you use a CPAP? How many hours a night? Are you sleepy during the day? Do you fall asleep while driving or at work?
  • Often 15-30 minutes.

Tests, in plain words

Sleep study (polysomnogram)
A test while you sleep, at a lab or at home, that counts how often your breathing stops. VA needs a sleep study to confirm the diagnosis.
AHI
Apnea-Hypopnea Index: how many times per hour your breathing stops or gets very shallow. 5-14 is mild, 15-29 is moderate, 30+ is severe (standard medical ranges; VA's current rating does not use AHI numbers).
CPAP usage report
Your CPAP machine records how many hours you use it. The app or your supplier can print it.

The examiner fills out a form called a DBQ. You can read it ahead of time: Sleep Apnea DBQ (opens VA's site).

The rating levels, in plain words

VA picks the level that best matches how often and how badly the condition affects you.

  • 0%

    A sleep study shows the breathing problem, but you have no symptoms.

    VA's exact words

    Asymptomatic but with documented sleep disorder breathing

    Rule: 38 CFR 4.97, DC 6847

  • 30%

    You stay very sleepy during the day, day after day.

    VA's exact words

    Persistent day-time hypersomnolence

    Rule: 38 CFR 4.97, DC 6847

  • 50%

    You need a breathing machine at night, like a CPAP (a mask that blows air to keep your airway open).

    VA's exact words

    Requires use of breathing assistance device such as continuous airway pressure (CPAP) machine

    Rule: 38 CFR 4.97, DC 6847

  • 100%

    Very serious: long-term breathing failure with carbon dioxide building up in your blood, heart failure on the right side caused by lung problems (cor pulmonale), or you need a breathing tube in your neck (tracheostomy).

    VA's exact words

    Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requires tracheostomy

    Rule: 38 CFR 4.97, DC 6847

What to track before your exam

What to write down: Your sleep study, your CPAP prescription, how often you use the machine, and daytime sleepiness.

How: Get a copy of your sleep study and the order for your CPAP. Print 30-90 days of CPAP use from the machine's app or supplier. For 2 weeks, also write down daytime sleepiness. Ask your spouse to note snoring, gasping, or stopped breathing they see.

Your log: what to write each time

  1. Date
  2. CPAP used last night? hours
  3. Woke up rested? (Y/N)
  4. Fell asleep or nodded off during day (where: TV, driving, work)
  5. Naps (#, length)
  6. Morning headache?
  7. Spouse saw stopped breathing or gasping?

Tap Print this page to get a blank log sheet and your exam-day checklist on paper.

Exam-day checklist

Tick each one off. Nothing you tick is saved or sent anywhere.

What to bring: Bring a photo ID, your list of medicines and doses, your home log, and any new private records you have not sent to VA yet. VA says you don't have to bring anything, but your notes help you remember. A spouse or caregiver may come along. VA says you can ask the examiner if they can stay in the room. The examiner may ask them to wait outside.

Tell the examiner

Honest exam rules

  • Tell the whole truth. Don't add to it. Don't shrink it.
  • Describe a normal day AND your worst days. Say how often the worst days happen.
  • Answer the question you were asked. Skip the habit of saying 'I'm fine' or 'it's not that bad' when it is.
  • It's OK to read from your log or notes. Hand the examiner a copy if they will take it.
  • Don't act out symptoms or guess at numbers. If you don't know or can't remember, say so.
  • If something hurts or makes you worse during the exam, say so right then.
  • Fraud warning: knowingly giving VA false information is a federal crime (18 U.S.C. 1001) and can cost you all your benefits (38 U.S.C. 6103). Honest, complete answers protect you.

Common mistakes

  • No sleep study in the file. Without one, VA usually can't confirm the diagnosis.

    Where this comes from: Sleep Apnea DBQ asks for the sleep study date and results; M21-1 requires sleep study confirmation (verify current M21-1 section on KnowVA)

  • Most denials are about whether service caused it, not the percent. Snoring or tiredness noted in service records, buddy statements from bunkmates, and a medical opinion help.

    Where this comes from: HTB practice note (secondary)

  • Not bringing proof of the CPAP prescription. The 50% level is about needing the device.

    Where this comes from: 38 CFR 4.97, DC 6847

  • Believing online posts that the 50% is already gone. It is still the law today.

    Where this comes from: eCFR 38 CFR 4.97 (unchanged since 2016) and Federal Register search Oct 30, 2026

Questions to ask together

A spouse, grown child or friend can read these out loud. Talk about each one before the exam, so nothing gets left out.

  1. Have I seen you stop breathing, choke, or gasp in your sleep?
  2. Do you use your CPAP every night? About how many hours?
  3. Do you fall asleep during the day without meaning to - TV, meetings, driving?
  4. Do you wake up with headaches or still tired?
  5. Did anyone notice snoring or tiredness when you were in the service?

Rule changes you may hear about

Today's rules (above) are what VA uses unless a change is final.

  • Proposed, not law yet

    VA proposed new sleep apnea levels based on how well treatment works: 0% if no symptoms with or without treatment; 10% if treatment helps only part way; 50% if treatment doesn't work or you can't use it due to another condition, without organ damage; 100% the same but with organ damage. Simply using a CPAP would no longer mean 50%.

    Where it stands: Proposed Feb 15, 2022. NOT final as of Oct 30, 2026. The 0/30/50/100 rules above still apply. VA has said existing ratings won't be cut just because the rule changes (38 U.S.C. 1155).

    87 FR 8474 (Feb 15, 2022), RIN 2900-AQ72; supplemental 89 FR 74162 (Sept 12, 2024, on constrictive bronchiolitis)

Sources

Checked against VA's rules on October 30, 2026.

Helping The Brave doesn't file or prepare claims. This guide is free education, not medical or legal advice. The VA examiner measures and VA decides your rating.