★ Respiratory
Central Sleep Apnea VA Rating
38 CFR § 4.97, Diagnostic Code 6847 (rated under the same sleep apnea code as OSA)
Overview
Central sleep apnea is a neurological breathing disorder — the brain temporarily fails to signal the muscles to breathe. There is no physical airway blockage (which is what distinguishes it from OSA).
CSA is most often secondary in veterans: chronic opioid therapy for service-connected pain, TBI, stroke residuals, congestive heart failure, and certain neurological conditions are well-recognized causes.
VA rates CSA under the same diagnostic code as obstructive sleep apnea (DC 6847). A prescribed breathing assistance device — including adaptive servo-ventilation (ASV) commonly used for CSA — supports the 50% rating.
How to Establish Service Connection
- Secondary to opioid medication used to treat a service-connected painful condition (back, knee, migraines, etc.) — opioids are a documented cause of CSA.
- Secondary to TBI or stroke residuals affecting the brainstem respiratory centers.
- Secondary to service-connected congestive heart failure or atrial fibrillation (Cheyne-Stokes respiration).
- Secondary to PTSD via prescribed psychiatric medications and disrupted sleep architecture.
- Direct service connection is rare but possible with in-service polysomnogram findings.
Rating Criteria
Paraphrased from 38 CFR § 4.97, Diagnostic Code 6847 (rated under the same sleep apnea code as OSA)
| Rating | Criteria |
|---|---|
| 0% | Asymptomatic but with documented sleep-disordered breathing on polysomnogram. |
| 30% | Persistent daytime hypersomnolence. |
| 50% | Requires use of a breathing assistance device (CPAP, BiPAP, or ASV). |
| 100% | Chronic respiratory failure with CO₂ retention or cor pulmonale; or requires tracheostomy. |
See what each percentage pays in 2026 and how it combines with your current rating →
Evidence Checklist
- Sleep study (polysomnogram) showing central apnea events — distinguished from obstructive events by absence of respiratory effort.
- Prescription for ASV, BiPAP, or CPAP machine.
- Medication list documenting long-term opioid use, if claiming secondary to opioid therapy.
- Cardiology or neurology records supporting the underlying causal condition.
- Nexus letter explicitly addressing the central (vs. obstructive) mechanism and tying it to the service-connected primary condition.
Common Secondary Conditions
Conditions frequently service-connected as secondary to Central Sleep Apnea:
Frequently Asked Questions
Useful Tools & Topics
Have a Central Sleep Apnea claim or denial?
Four fields. A VA-accredited claims agent reviews it and responds within 3–5 business days. Contingent fees apply only to awarded past-due benefits on appeals — never on initial claims.
Requesting a consultation does not create representation and is not a guarantee of any outcome. Representation begins only after a written fee agreement and VA Form 21-22a are signed.
Educational content only — not legal advice and not medical advice. Rating criteria on this page are summarized in plain English from 38 CFR Part 4; consult VA.gov or the current Code of Federal Regulations for official criteria. This page provides general education about how the VA rates this condition; it is not individualized advice, does not establish a representation relationship, and should not be used to self-diagnose, self-treat, or decide a course of action without speaking to a qualified clinician and a VA-accredited representative. Outcomes depend on each veteran's individual facts, evidence, and the adjudicator's judgment; no specific rating, effective date, or other result is guaranteed. Oakridge Claims is a private business and is not affiliated with, endorsed by, or operated by the US Department of Veterans Affairs.
Related Conditions
Sleep Apnea (Obstructive)
CPAP-required ratings (50%), and connecting OSA secondary to PTSD or sinusitis.
PTSD (Post-Traumatic Stress Disorder)
Service-connected PTSD ratings, common stressors, and evidence strategy.
Traumatic Brain Injury (TBI)
10 facets of cognitive impairment and overlap with mental health ratings.
Coronary Artery Disease (Ischemic Heart Disease)
METs-based rating; Agent Orange presumptive.