Citation Nr: 18148332 Decision Date: 11/08/18 Archive Date: 11/07/18 DOCKET NO. 11-17 315 DATE: November 8, 2018 ORDER Entitlement to service connection for sleep apnea is granted. FINDING OF FACT The Veteran’s sleep apnea is etiologically related to active service. CONCLUSION OF LAW The criteria for service connection for sleep apnea are met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from July 1981 to June 1995. In May 2018, the Veteran testified at a Board hearing. The transcript is of record. 1. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303. “To establish a right to compensation for a present disability, a veteran must show: ‘(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service’ – the so-called “nexus” requirement.” Holton v. Shineski, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). The Veteran contends his sleep apnea is related to active service. For the following reasons, the Board finds that the service connection for sleep apnea is warranted. In October 2016 the Veteran attended a VA examination. The examiner noted the diagnosis of sleep apnea and the Veteran’s report of persistent daytime hypersomnolence. The examiner opined that it is less likely than not that the Veteran’s sleep apnea is caused by an in-service injury, event or illness due to a lack of definite sleep apnea related complaints in the service treatment records. The examiner also explained that increasing age and weight gain are the two strongest risk factors for sleep apnea and noted that it has been about 18 years since the Veteran separated from service and he has gained weight during that time. In August 2016, the Veteran provided a disability benefits questionnaire (DBQ) by Dr. C.S., who noted a history of snoring, poor sleep, breathing pauses during sleep, and persistent daytime hypersomnolence. Dr. C.S.opined that it is more likely than not that the Veteran developed sleep apnea on active duty based on her review of the medical records, service treatment records, and sleep history. According to Dr. C.S., the Veteran’s sleep apnea developed between 1981 to 1985 based on reports from family members and others that he would snore disruptively and have breathing pauses during sleep and the Veteran’s reports of poor sleep quality and fatigue, which are all symptoms of obstructive sleep apnea. Dr. C.S. also noted that the Veteran is service connected for posttraumatic stress disorder (PTSD) and research shows sufferers of PTSD are more likely than other adults to have undiagnosed sleep apnea. Additionally, Dr. C.S. pointed out that the Veteran’s service connected gastroesophageal reflux disease (GERD) is a symptom of sleep apnea. When making a decision, the Board must consider all the evidence of record, to include lay statements. 38 U.S.C. § § 5107(b), 7104(a); 38 C.F.R. § 3.303(a). In May 2018, the Veteran testified that he suffered from daytime hypersomnolence and snoring during active service. The Board finds the Veteran’s testimony to be competent and credible. See Barr v. Nicholson, 21 Vet. App. 303 (2007). As such, the Veteran’s testimony is afforded probative weight. Furthermore, the Board gives significant weight to the opinion of Dr. C.S. This opinion was conducted by an expert in the field of sleep medicine, who reviewed the record and conducted a physical examination. Dr. C.S.’s opinion is supported by a thorough rationale with a well-reasoned medical explanation with citations to the evidence of record. See Nieves- Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Conversely, the Board affords little probative weight to the opinion of the VA examiner. The examiner relied on a lack of definite complaints of sleep apnea in the service treatment records and failed to properly consider the Veteran’s statements of daytime hypersomnolence and reports of snoring in service. Additionally, the VA examiner cited the Veteran’s weight as a risk factor; however, the record reflects that the Veteran has undergone significant weight loss due to his GERD, which has not resulted in an improvement with his sleep apnea symptoms. As such, the Board finds that service connection for sleep apnea is warranted. G. A. WASIK Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. A. Prinsen, Associate Counsel