Jump to content


Photo
- - - - -

Hypertension And Obstructive Sleep Apnea


This topic has been archived. This means that you cannot reply to this topic.
16 replies to this topic

#1 yelloownumber5

yelloownumber5

    E-5 Petty Officer 2nd Class

  • First Class Petty Officer
  • PipPipPipPipPip
  • 195 posts

Posted 17 January 2008 - 10:37 AM

Hello,

I'm rated for hypertension within my year of retirement 12/2003. In March of 2006, I had my first sleep study and second in Oct and diagnosed with Obstructive sleep apnea and insomnia but did not file a claim because my representitive told me that since this was after the one year period I was "not qualified to file". Anyhow....while on active duty I did complain of day time fatigue and on my physicals but "sleep 10-12 hours but still tired throughout the day and yawnny". I was asked if I snore but being single I did not know....blah blah blah. In 2004 actually my wife did say I have apnea events. While on active duty right before retirement I had a deviated septum which I had surgery on to help with the day time fatigue but that still did not help and I told the doctors such. I did claim the deviated septum but had problems proving the trauma.......anyhow..........


Would it be within reason to file a claim with the Obstructive Sleep Apnea secondary to hyptertension (systemic). Is this resonable on my behalf? I also have GERD which has developed to Barretts Esphogus which I have read causes OSA as well........how do they decide? I also need to request an increas on my GERD from the 10 percent I guess.


Thanks much in advance,



Y#5

#2 71M10

71M10

    E-8 Senior Chief Petty Officer

  • Senior Chief Petty Officer
  • PipPipPipPipPipPipPipPip
  • 1224 posts

Posted 17 January 2008 - 01:34 PM

I also have sleep apnea and believe it started in service but alas not enough medical evidence, my doctor thinks it started in service and has put it in writing but I have not submitted since it is still weak on evidence.

As I understand it (my own web research) the Sleep apnea causes hypertension and Gerd not those conditions cause sleep apnea.

Im working on getting my hypertension SC first (diagnosis in SMR's with extensive work-ups by internists ect) and my cardiomegaly (enlarged heart).

Im currently trying to track down buddy statements (22 people in 1 quansit hut) so if you know anyone from HHB 6/37 FA Uijongbu Korea 11/85-10/86 have them e-me!

Since your apnea diagnosis is fairly close to your hypertension see if you can get a pulmonologist (sp) who is also board certified in sleep medicine, to do an exam and medical opinion/nexus statement. They may be willing to state 100% that your Hypertenstion and GERD are caused by Sleep Apnea and that would put it within the presumptive period.

People have also won sleep apnea after the one year period because of deviated septem treatment in service. The key here is a good medical statement connecting the dots.

Best regards,

Tyler

#3 yelloownumber5

yelloownumber5

    E-5 Petty Officer 2nd Class

  • First Class Petty Officer
  • PipPipPipPipPip
  • 195 posts

Posted 17 January 2008 - 08:08 PM

71M10,

I was trying to go this route because it has been hard for me to get buddy statements. I as well have a deviated septum but that has to be proved cause by trauma which I'm sure mine did but I am missing a lot of medical pages (even missing from the VA) during the time of my car accident but as well have cervical issues and Trauma related Cateract which are more than likely all related to the accident.

There is a lot of info about GERD causing OSA.....with hypertension you are correct osa can cause that not vice versa as I was saying. I know GERD in my severity can cause lots of problems so make sure yours stays in control.

#4 Ricky

Ricky

    E-9 Master Chief Petty Officer

  • Master Chief Petty Officer
  • PipPipPipPipPipPipPipPipPip
  • 2116 posts

Posted 18 January 2008 - 02:40 AM

Lets see here. The medical community is split at about the 70 to 30 on which came first hypertension or OSA. The bad think is the 70 percent is aginst the theory that hypertension causes OSA and provide that OSA aggravates hypertension. However, if you can get the doc to do an IMO providing that your day time sleepy problems, your claims of sleep problems on the physical, the hypertension and the Gerd was at least as likely to have symptoms/diagnosed illness's were indicators of your OSA in service you may just have a chance. I have seen/heard of some that have succeeded like this. Good luck.

#5 yelloownumber5

yelloownumber5

    E-5 Petty Officer 2nd Class

  • First Class Petty Officer
  • PipPipPipPipPip
  • 195 posts

Posted 20 January 2008 - 12:33 PM

Lets see if this will let me reply now......two hours ago it disappreared on me.....


Ricky,

Right was it the chicken or egg first? I was just looking at different angles for my Sleep Apnea claim. I finally received a copy of my medical record and there were of course no diagnoses while on active duty for OSA however...in my last 3 years of active duty my medical record has some mention of sleep disorders, day time fatigue and the doctor said "osa 2* (2 degree)" "consider sleep study" but I never had one and for my final year in the military I had a new PCM which this never got discussed becaue I was looking at cervical surgery before I retired. I am awaiting a copy of my record from retirement (12/31/2003) to present. In mid 2006 I told my different PCM that I was falling sleep while driving because before this he never did anything when I complained of day time fatigue but i did not complain very much. I had my first sleep study 10/31/2006 and was diag with insomnia and OSA. My blood pressure was and still is uncontrollable during this time of talking about sleep apnea......

Do you think I should submit a claim like this? I was going to claim before but my VSO Rep told me I didn't have a well grounded cause.


Thanks for your assistance,



Y#5

#6 Ricky

Ricky

    E-9 Master Chief Petty Officer

  • Master Chief Petty Officer
  • PipPipPipPipPipPipPipPipPip
  • 2116 posts

Posted 22 January 2008 - 01:44 AM

Yellow - as I posted before you will need a VERY STRONG medical opinion. Although your SMR's have indications of possible OSA it was not diagnosed until several years after your service. Now if the sleep doc will provide an opinion that all of your symptoms in service, the suspected OSA, the GERD and hypertension were at least as likely as not due to OSA then you will be on the road to success (jmho)

Now along with this if you have a better half or some buddies that can attest to the fact (lay evidence of symptoms) that you snored and appeared to quit breathing during that time should put icing on your claim. It will be hard to win this at the RO level but with all of the evidence that I have listed the BVA may just weigh in your favor. If I had been your VSO and you could have obtained such evidence I would have recommeded that you submit the claim. My recommendation would have been based upon the fact that most people have sleep apnea for several years before they realize they have it. I am not saying that your SO was wrong for his recommendation - we all have different opinions!

We all have similar symptoms due to normal life. You know sometimes we party, fight with the better half or study for a test way to late in the night which causes us to fall asleep during the day. However, when it gets to the point that these symptoms are almost daily then there is a problem. The military response to such symptoms, most of the time, is go to bed earlier and do more PT. And oh by the way, just incase that does not work here's some motrin! :) Good luck.

Edited by Ricky, 22 January 2008 - 01:48 AM.


#7 71M10

71M10

    E-8 Senior Chief Petty Officer

  • Senior Chief Petty Officer
  • PipPipPipPipPipPipPipPip
  • 1224 posts

Posted 22 January 2008 - 10:20 AM

Yep Agree with Ricky!

Waking up on the wrong side of the road is only interesting so many times :)

#8 yelloownumber5

yelloownumber5

    E-5 Petty Officer 2nd Class

  • First Class Petty Officer
  • PipPipPipPipPip
  • 195 posts

Posted 22 January 2008 - 01:23 PM

Ricky,

I will have to work on getting some statements, do we use the 2138?

My wife (which hers probably won't count for much being my wife but she is a nurse and her mom a doctor - we just don't get too much into this) is the one that found it out. I mean you can only tell a doctor your problems and hope they do the tests. I was just leaning towards a approval since he said he I had traits of OSA and he should consider doing the test. We know the symptoms of our cars when we drive it everyday.....so I had to lie and tell my new PCM that I "fell asleep while driving" because he would not give me a sleep study even though I told him I was having the fatigue.......this went on for years and on my physicals. You know after I told him I fell asleep......within a month I had a sleep study and from that I had OSA. Incredible. Not that that should get me an approval but it is incredable that all in all you can tell your doctor and he can do what they want......another thing.......thyroid.........OMG you know I told my doctor while on active duty I had a thyroid issue.....you know he did test it and it jumped from good to bad almost each time. The VA Neuro even told them to check it more indepth and they never did......guess what.....after fighting with them and finally getting my internal medicine doctor to do his "tests" and finding nothing I was sent to an endo who said........."um, yes you that thyroiditis". Then next time I seen the internal medicine doctor for the first time ever....he said he could feel my nodule, lol.
Which is funny because I was also involved in a duty van single car accident....hmmm, no Naval Hospital Pensacola ER notes. Navy legal did have a bill in there because they had me do a drug test to see if they could make me pay for the vehicle, lol.

Another question.....is there some code that deviated septum might fall under besides 6502? And quesiton of the day....if they went to fix a deviated septum by doing septoplasty but they made it worse and you still have a deviated septum, should you not be able to claim that.....I need guidance if that is possible. the problem with claiming a deviated septum under 6502 is it had to be from trauma and without record of trauma - no sc.

One gets tired of playing nicely while the others do not play so nice.

But back to the response. I appreciate you suggestions and am making an appointment with my sleep study doctor.

By the way......Motrin always topped the list but it was good for other reasons.




Yellow - as I posted before you will need a VERY STRONG medical opinion. Although your SMR's have indications of possible OSA it was not diagnosed until several years after your service. Now if the sleep doc will provide an opinion that all of your symptoms in service, the suspected OSA, the GERD and hypertension were at least as likely as not due to OSA then you will be on the road to success (jmho)

Now along with this if you have a better half or some buddies that can attest to the fact (lay evidence of symptoms) that you snored and appeared to quit breathing during that time should put icing on your claim. It will be hard to win this at the RO level but with all of the evidence that I have listed the BVA may just weigh in your favor. If I had been your VSO and you could have obtained such evidence I would have recommeded that you submit the claim. My recommendation would have been based upon the fact that most people have sleep apnea for several years before they realize they have it. I am not saying that your SO was wrong for his recommendation - we all have different opinions!

We all have similar symptoms due to normal life. You know sometimes we party, fight with the better half or study for a test way to late in the night which causes us to fall asleep during the day. However, when it gets to the point that these symptoms are almost daily then there is a problem. The military response to such symptoms, most of the time, is go to bed earlier and do more PT. And oh by the way, just incase that does not work here's some motrin! :) Good luck.


Edited by yelloownumber5, 22 January 2008 - 02:07 PM.


#9 Ricky

Ricky

    E-9 Master Chief Petty Officer

  • Master Chief Petty Officer
  • PipPipPipPipPipPipPipPipPip
  • 2116 posts

Posted 23 January 2008 - 10:15 PM

The statements from a wife as long as she is only commenting on symptoms is always probative. As a matter of fact, your wife/girlfriend or other bed fellow, would be in a perfect position to comment on OSA symptoms experience since they only occur when you are alseep. Now if they were from a neighbor who was saying that you rattled his walls at night then they probably would not be probative.

Depending on the type of nurse your wife is she may even be allowed to delve into the diagnosis side of it. Also if your mother-in-law is a GP doc and she is willing to review your military medical records, the sleep test etc..... and provide an opinion as to the issue at hand that would also be probative.

On your other question you are correct there must be trauma. I will do some research on the issue but do not know if there is a way around it. Maybe someone on Hadit has worked a claim such as this or suffers from the same and can be more helpful. Good luck with the OSA.

PS make sure the sleep doc understands that you are only asking for an at least as likely determination (50/50). For some reason sleep docs do not like to place any kind of start date on OSA. Maybe they think that doing so will curse them for life. Most GP docs don't have a problem at all.

#10 yelloownumber5

yelloownumber5

    E-5 Petty Officer 2nd Class

  • First Class Petty Officer
  • PipPipPipPipPip
  • 195 posts

Posted 24 January 2008 - 08:08 AM

Ricky,

Concerning my OSA are you saying something like?

"This case of OSA is at least as likely as not caused by GERD and Hypertension" or are we talking about "during active duty service"



Thanks.

The statements from a wife as long as she is only commenting on symptoms is always probative. As a matter of fact, your wife/girlfriend or other bed fellow, would be in a perfect position to comment on OSA symptoms experience since they only occur when you are alseep. Now if they were from a neighbor who was saying that you rattled his walls at night then they probably would not be probative.

Depending on the type of nurse your wife is she may even be allowed to delve into the diagnosis side of it. Also if your mother-in-law is a GP doc and she is willing to review your military medical records, the sleep test etc..... and provide an opinion as to the issue at hand that would also be probative.

On your other question you are correct there must be trauma. I will do some research on the issue but do not know if there is a way around it. Maybe someone on Hadit has worked a claim such as this or suffers from the same and can be more helpful. Good luck with the OSA.

PS make sure the sleep doc understands that you are only asking for an at least as likely determination (50/50). For some reason sleep docs do not like to place any kind of start date on OSA. Maybe they think that doing so will curse them for life. Most GP docs don't have a problem at all.



#11 Ricky

Ricky

    E-9 Master Chief Petty Officer

  • Master Chief Petty Officer
  • PipPipPipPipPipPipPipPipPip
  • 2116 posts

Posted 24 January 2008 - 06:38 PM

Something like - After a complete review of the veterans service military service records it is evident that he suffered from several other medical conditions that the medical community agrees are closely associated with; hypertension, Gerd etc...etc... what ever your had----- Along with this the veteran complained of day time sleepiness, tirdeness etc etc etc.... all of which are considered to be symptoms of OSA. Therefore based on the current acceptance of theses facts along with the demostrated OSA symptoms it is my medical opinion that his OSA at least as likely had its onset at the time of his initial complaints while in military service.

NOT EXACTLY LIKE THIS but you get the dirft.

#12 yelloownumber5

yelloownumber5

    E-5 Petty Officer 2nd Class

  • First Class Petty Officer
  • PipPipPipPipPip
  • 195 posts

Posted 27 January 2008 - 10:04 PM

Ricky,

Yes and thank you very much. I while back I think Berta had guidelines or example regarding the IMO's but I didn't could not find them.



Have a great week!!



Something like - After a complete review of the veterans service military service records it is evident that he suffered from several other medical conditions that the medical community agrees are closely associated with; hypertension, Gerd etc...etc... what ever your had----- Along with this the veteran complained of day time sleepiness, tirdeness etc etc etc.... all of which are considered to be symptoms of OSA. Therefore based on the current acceptance of theses facts along with the demostrated OSA symptoms it is my medical opinion that his OSA at least as likely had its onset at the time of his initial complaints while in military service.

NOT EXACTLY LIKE THIS but you get the dirft.



#13 jbasser

jbasser

    Moderator/HadIt.com Elder/SVR Radio Panelist

  • Admin
  • PipPipPipPipPipPipPipPipPip
  • 6167 posts

Posted 28 January 2008 - 11:26 AM

Sleep Apnea is a condition that aggravates hypertension. Hypertension is listed as essential hypertension for anyone does not know the spacific cause.

If you are service connected for hypertension, OSA can be rated as an aggravation factor. It does not matter if it was developed in service to get connected for it.

Now in the worst case, sleep apnea can also lead to pulmonary hypertension and cardiac problems like right side heart failure. The Electrical circuitry can be disturbed causing the heart to quiver instead of beat to pump blood and a person can die in his sleep suddenly.

Edited by jbasser, 28 January 2008 - 11:32 AM.


#14 yelloownumber5

yelloownumber5

    E-5 Petty Officer 2nd Class

  • First Class Petty Officer
  • PipPipPipPipPip
  • 195 posts

Posted 04 February 2008 - 04:06 AM

jbasser,

yes osa is nothing to play with. my wife has it also and not sure what caused it but she has issues with her tricusips valve (spelling?). My internal medicine doctor just dignosed my hypertention as sysmatic, I have many issues and cannot think clearly but I'm thinking that he is saying the hypertension is connected to something, correct?

Thanks.



Sleep Apnea is a condition that aggravates hypertension. Hypertension is listed as essential hypertension for anyone does not know the spacific cause.

If you are service connected for hypertension, OSA can be rated as an aggravation factor. It does not matter if it was developed in service to get connected for it.

Now in the worst case, sleep apnea can also lead to pulmonary hypertension and cardiac problems like right side heart failure. The Electrical circuitry can be disturbed causing the heart to quiver instead of beat to pump blood and a person can die in his sleep suddenly.



#15 stillhere

stillhere

    E-8 Senior Chief Petty Officer

  • Senior Chief Petty Officer
  • PipPipPipPipPipPipPipPip
  • 1361 posts

Posted 05 February 2008 - 08:54 AM

I am also trying to get my sleep apnea connected to my gerd,and hypertension. My cardio dr called yesterday and is going to write a letter trying to connect it to the hpertension and cad. If you are interested I will post part of the letter.

i am sc for dmii,cad,pn hypertension (but no rating)

Stillhere

#16 yelloownumber5

yelloownumber5

    E-5 Petty Officer 2nd Class

  • First Class Petty Officer
  • PipPipPipPipPip
  • 195 posts

Posted 05 February 2008 - 12:13 PM

Stillhere,

Sure if you don't mind. I see my sleep doctor this friday. Even though I've been diagnosed with OSA and insomnia my PCM and Internal Medicine doctors WILL NOT give me sleep piils not even at the lowest dosage. They both told me no but in my medical record they wrote something to the extint of told patient to come in and discuss Rx for sleep meds --- C-y-a?
I find that incredible......I've even told them I will not and do not use them daily.....usually I use meletonin but somethings it is nicer to have something that will "knock" you out...I know I can only go about a week with no sleep and then there is hell to pay, lol.


There is a lot of evidence connecting the 3 together. Personall I know I had GERD first, then probably sleep apnea follewed by Hypertension..........whether GERD played a roll or not I don't really know but for your with SA your pressure will take off. Mine was pretty bad 190/120 this was due to stress, NO SLEEP, and I could not use my cpap for about 3 weeks. So please keep rolling with the program to keep it at bay.



Y#5


I am also trying to get my sleep apnea connected to my gerd,and hypertension. My cardio dr called yesterday and is going to write a letter trying to connect it to the hpertension and cad. If you are interested I will post part of the letter.

i am sc for dmii,cad,pn hypertension (but no rating)

Stillhere


Edited by yelloownumber5, 05 February 2008 - 12:14 PM.


#17 stillhere

stillhere

    E-8 Senior Chief Petty Officer

  • Senior Chief Petty Officer
  • PipPipPipPipPipPipPipPip
  • 1361 posts

Posted 05 March 2008 - 12:53 PM

Meant to get this to you sooner. Hope it helps. stillhere

To whom it may concern:

I am asked to provide documentation of disability for xxxx. He suffered a myocardial infarction in 2005 with emergency right artery stenting from an occluded right coronary artery. He went on to develop recurrent coronary disease with circumflex stenting in 2006. He has hypertension, hyperlipidemia, diabetes mellitus and sleep apnea. He is mediated on Coreg,Losartin, Aspirin, Metformin and Plavix for his multiple cardiac factors and health conditions. He additionally carries a diagnosis of sleep apnea. It has been established that sleep disorder breathing such as sleep apnea is common in men with coronary artery disease and is associated with coronary artery disease.

I would note that diabetes is a significant risk factor for conorary artery disease. I would note that diabetes mellitus has been identified as a deveolpmental condition following exposure to agent orange. The patient served in Vietnam 1969-1970 with exposure to Agent orange.

On the basis of these notations of sleep apnea, coronary artery disease, diabetes mellitus and hypertension, I would suggest a thorough re-evaluation of his disability status.