Between late 1991 thru 2/1997, my girlfriend, ex-girlfriends, family, friends, associates complained to me that I snore extremely loudly, stop breathing when I am asleep; seem fatigue throughout the day; fall asleep at very odd times (i.e. when driving, sitting in meetings, at church, or just sitting still); wake up gasping for air; is gaining weight; and told me I used the bathroom too much (average 8 to 10 times daily). Between 1991 thru 1997 I also began noticing the frequency in which I had indigestion; and that I was also gaining a lot weight.
During that same timeframe (1991 thru 1997) I also went through a period of depression, moodiness, work related stress, insomnia and most embarrasing (no sexual stamina).
In 9/2001 I was diagnosed with Severe Obstructive Sleep Apnea. I was told I stop breathing 36 times an hour.
I have 5 questions:
1.) My problem is that in 1993 I was diagnosed with FATIGUE. I often wondered if the doctor or Physician assistant, mistakenly misdiagnosed me, because girlfriends, family, friends and associates have observed me having the above symptoms since 1991.
2.) How well educated was the military and civilian medical communities on the diagnosing sleeping disorders, especially Obstructive Sleep Apnea between 10/1991 thru 2/1997.
3.) Since obstructive sleep apnea doesn't appear to be something you get overnight how long does it take for a person to start having the above symptoms I mentioned earlier?
4.) Is it possible that I had obstructive sleep apnea several years before I was diagnosed (9/2001), even though it was undiagnosed while I was on active duty.
5.) What is the etiology for ostructive sleep apnea?
In talking with other people who have been diagnosed with obstructive sleep apnea, they were not aware they were having this major health problem, until there wives, girlfriends, or whomever observed them started complaining to them over and over about the above symptoms I mentioned earlier. It took 10 years of complaints from family, friends, associates, and girlfriends, one in particularly which I did not want to lose to get me to go to the doctor; and the additional fact that I was not allowed to spend the night a at family, friend, and a few women I dated over the years home due to the above observed symptoms really hurt me.
9/2001 I decided to go to the doctor with my current girlfriend who told the doctor that she observed tha I snore excessively loud and that I stop breathing when I am asleep. The doctor had me do a sleep test and turn the results of that test in. Later that same month (9/2001) I was diagnosed with severe obstructive sleep apnea.
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obstructive sleep apnea often develops gradually, over a period of several years. The medical community has become increasingly aware of OSA since the mid 1990's. It started to be described in the med literature in the mid 70's. CPAP was invented in 1981.
Fatigue is a nonspecific symptom that can be due to OSA, psych disorders, various medical conditions, cancer, etc.
Dr. Michael Rack,
Thank you so very much for the answer you sent me on 10/21/2007 at 6:33pm to my questions concerning the etiology of OSA. I had no idea that OSA, and I am quoting you, "obstructive sleep apnea often develops gradually, over a period of several years."
Dr. Rack, could you provide me answers to the below questions.
1. Where can I find out more information on how long it takes for a person to get severe obstructive sleep apnea?
2. What are the early symptoms of OSA?
3. How long does it take for a person with sleep apnea to progress to obstructive sleep apnea, then progress to severe obstructive sleep apnea?
4. Dr. Michael Rack, do you know a specialist in San Diego County that you would recommend for me to consult with?
Your help has been most appreciated.
Thanks again.
Sincerely,
A. M. Lane
don't know any specialists in san diego personally; you can check the American Academy of Sleep Medicine web site to find an accredited sleep center in your area (google American Academy of Sleep Medicine).
common symptoms of obstructive sleep apnea include snoring and sleepiness. Some things that could cause rapid development of sleep apnea include rapid weight gain or the sudden development of a medical disorder (hypothyroidism, stroke, congestive heart failure) that can cause sleep apnea. Congestive heart failure can cause both obstructive and central sleep apnea. I encourage you to find a sleep physician in your area to sort out your case.
good luck
Dr. Rack,
Thank you for answering my questions. I have been trying to find answers to several of my questions. Until talking with you, trying to find out how long a person can have SOSA before it is diagnosed seemed to be impossible question to get an answer to. Especially for people who had symptoms of SOSA from 1991 thru 1997.
I am a recently retired Air Force member who was diagnosed with severe sleep apnea approximately 8 months after retirement. During the past 5 years I've had numerous documented hospital visits for morning headaches, hypertension, and several complaints of memory loss. Since I've never complained about morning fatigue and drowsiness (which were frequent), and was not diagnosed with sleep apnea while on active duty, the VA has denied my claim for disability for this condition. I am considering submitting an appeal to this decision and would like to know if you recommend any reference that support the fact that it is not common to develop this condition is such a short period, and hopefully substantiate my claims that this condition was present while serving on active duty in the Air Force.
Any assistance would be greatly appreciated.
v/r
Andy McLean
I am a retired Army member who was just diagnosed with severe sleep apnea about 4 months ago. I went to the VA Hospital at the suggestion of a fellow veteran for the sleep study, because I was still having the same symptoms. When I retired in October 2005, my VA rep put down "Insomnia", based on what was in my records...which started when I got back from Iraq. I only went to sick call once, and the doctor gave me "Ambien"...my problem with sleeping didn't go away, and I didn't want to keep taking pills. VA denied my original claim for "Insomnia" because I only went to the doctor once, and it was not chronic. I now realized that it may have been OSA. When I went in for my physical, the doctor who reviewed my records didn't mention "Sleep Apnea", and for that matter, I didn't know what Sleep Apnea was until last year.
So after I was diagnosed by the VA Hospital here in North Carolina, and given a CPAP machine, I decided to file a claim for Service-Connection, based on misdiagnosis for "Insomnia". It was denied for Service-Connection. I spent 21 years in the Army, and for VA to infer that I just acquired OSA is an insult. For the past 3 years since I've retired, I still was not sleeping fully through the night, and now I have to put on a damn mask every night. I haven't rapidly gained any weight over the past 3 years...but I still feel tired during the day and if I don't wear my mask, I suddenly jerk myself awake in the middle of the night. I don't understand this at all...especially after serving over 20 years in the military.
I have put in 2 claims with the VBA for service connected sleep apnea (both denied). I got out of the marines when very little was known about sleep apnea 2/1997 but I had several symptoms documented in my military medical records that were simply overlooked due to medical personnel were just not familiar with sleep apnea as they are now, and the truth be told, there is still low awareness of the disease to this day. I went online and found several medical articles, especially VBA appeals cases where veterans had to appeal just to be diagnosed. I even found a book written by a doctor who has been board certified since 1986. I found 3 VBA cases where the Veterans were diagnosed 3, 8, and 35 years laters after being honorably discharged. All had very very little to no evidence, one actually had no evidence documented in there military medical records. Look up sleep apnea medical articles under emedicine, wikipedia, American Family Practice, etc. I am about to submit a third claim because I found out that the VBA raters are not Board Certified Sleep Specialist; yet they are making decisions on persons health. Got to ABSM.ORG, this website will tell you what doctors are board certified. Read the entire webpage after you use the internet to find articles on sleep apnea. I asked myself this question, how can a person deny my sleep for service connected sleep apnea if he/she is not a board certified specialist in that field. Board certifications means the person is an EXPERT.
A few questions and comments.
I do have OSA which was DX'd with a sleep study in Oct 2007 and triation March 2008.
My sleep doctor said the reason was 1. Weight 2. Contributions from nasal obstruction.
He did comment on my deviated septum.
I wasn't found to have any specific allergies but been on Flonase and Nasalex (spelling) and others for a while In Aug 2003 I did have septoplasty surgery to correct a deviated septum. In 2006 I did not have a deviated septum but then in 2007 I was told I have a deviated septum. I do have cysts still in a few of my sinus cavities.
I also was in the military and have documented sleep issues while on active duty and PCM states "OSA 2 degrees".
I do not know how my OSA claim will go but I do know I had it while on active duty, but my deviated septum is not service connected at this time and I don't have full evidence to get it connected (it was denied once). I did have a bad car accident while in the military and actually on duty.........but they did not do an xray and no records from the ER (military er)
If you have any of these symptoms (i.e. snoring, observed not breathing during sleep events, fatigue, weight gain issues, sinus problems, daytime sleepiness) documented in your medical records you stand a great chance of getting your sleep apnea claim through. If you have have been diagnosed and issued the CPAP machine you will definitely get 50% disability.
On active duty - I was overweight for 6 years, excessive and unexplained weight gain; unexplained fatigue, observed not breathing during sleep, prehypertension, infrequent migraine headaches, heartburn 3 to 4 times weekly.
log on to the internet and type in SLEEP APNEA SYMPTOMS, CAUSES AND RISK FACTORS, then go through your medical record and find those medical problems.
I had a claim denied even though I took my CPAP machine to my C&P examination. Sleep Apnea is not presumptive to military service. You need to have a medical diagnoses in your service medical records or a doctor say it is more likely than not service connected. I even had my OSA documented in my SMR and they still denied it.
The VA likes to say preexisting conditions or a person's wieght caused the OSA. Your only chance is to have a doctor clearly say it was caused by your military service if it didnt start while you were active duty.
Did you appeal it? I have found several appeal granted because they were specificaly complaints of sleep issues and the doctor said "OSA" or "sleep apnea", "submit sleep study".........that is stange if yours was denied at this level because all the ones I read say basically said the veteran cannot be penelized because the military did not follow through with a sleep study.
I sure hope you appealed if the informaiton you stated is in your SERVICE MEDICAL RECORD and look up some VBA decisions.
Good Luck.
I went another route, which I will go into in a moment. In my case, I had a sleep study done while I was in the military. I brought copies of my SMR to the C&P examination but not the actual sleep study because I figured that it being in my records was enough. I was wrong. They said that I was not a medical doctor and thus having no reason why the OSA was diagnosed at the hospital, (Walter Reed) while in the military, my saying it was diagnosed and showing the C&P examination doctor my copy of my SMRs was not considered proof... Those reading this are probably saying what I said... BS! Rather than appealing, I submited the sleep study and my cpap receipt with a current sleep study via the VCAA notice forcing them to readjuctate the claim and trying to avoid a lengthly appeal. I recieved a letter yesterday stating they are reworking it. I already have another Independent Medical Opinion letter for a final nail in the VA coffin.
That is what I'm trying but having a difficult time getting an IMO. Anybody have some names of doctors for IMO's for doctors doing sleep apnea prefer board certified.
Thanks in advance,
Great question! Does anyone know a certifed sleep doctor that will do an IMO for sleep apnea upon review of records/evidence.
Tanka thanks you.
My VA doctor just simply said my sleep apnea was LESS than likely I had it during my time in the Army. I talked to him for 15 minutes and I had statements from old army buddies and my EX-WIFE who knew I had a snoring problem and stoppped breathing during the night. But in 15 minutes this doc knew more about me then someone who knew me for 30 years !!!! all messed up. Plus the Va denied me too.