Citation Nr: 18143422
Decision Date: 10/19/18	Archive Date: 10/19/18

DOCKET NO. 16-33 720
DATE:	October 19, 2018
REMANDED
Entitlement to service connection for sleep apnea is remanded.
REASONS FOR REMAND
The Veteran served on active duty from May 1976 to March 1977 and from November 1990 to August 1991.
This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a October 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Winston Salem, North Carolina.
The Veteran was notified of his right to a personal hearing before the Board, but the Veteran declined.
Entitlement to service connection for sleep apnea is remanded.
The Veteran contends that he is entitled to service connection for sleep apnea.  The Veteran submitted a private opinion indicating that his currently diagnosed sleep apnea was aggravated by his service-connected posttraumatic stress disorder (PTSD).  The private medical opinion was corroborated by medical literature suggesting an association between PTSD and sleep apnea.  The Veteran was provided a VA medical opinion, but it did not indicate whether the Veteran’s sleep apnea could have been aggravated by his PTSD.  Once VA undertakes to provide the Veteran with a VA examination, it must provide the Veteran with an adequate one, and, an adequate examination, is sufficiently detailed to provide a complete analysis of the Veteran’s condition.  Bar v. Nicholson, 21 Vet. App. 303 (2007).
The matter is REMANDED for the following action:
1. Copies of updated treatment records should be obtained and added to the claims file.
2. Following completion of the above, arrange to provide the Veteran with a VA examination in order to address the following:
(a.) Is it at least as likely as not (50 percent or more) that the Veteran’s sleep apnea is proximately due to or aggravated by the Veteran’s service-connected PTSD.
(b.) If the Veteran’s sleep apnea was aggravated by his PTSD, then provide a base line estimate of the severity of the Veteran’s sleep apnea absent the effect of the Veteran’s PTSD.
(c.) What is the significance, if any, of the following medical literature: Amir Sharafkhaneh, Nilgun Giray, Peter Richardson, Terry Young, and Max Hirshkowitz, Association of Psychiatric Disorders and Sleep Apnea in a Large Cohort, SLEEP, Vol 28, No. 11 (2005).  See VBMS, 
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7/7/15, Medical Treatment Record – Non-Government Facility.
 
BARBARA B. COPELAND
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	David R. Seaton, Associate Counsel