Citation Nr: 18152848 Decision Date: 11/26/18 Archive Date: 11/26/18 DOCKET NO. 15-03 781 DATE: November 26, 2018 ORDER Entitlement to service connection for sleep apnea is denied. FINDING OF FACT Sleep apnea did not have its onset during active service and is not otherwise related to active service. CONCLUSION OF LAW The criteria for service connection for sleep apnea have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from July 1981 to November 1981 and from September 1983 to March 1992. 1. Entitlement to service connection for sleep apnea. Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 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 Veteran claims entitlement to service connection for sleep apnea. As to the first element of a service connection claim, a current disability, the Board finds that post-service private treatment records document an assessment of severe obstructive sleep apnea following a May 2013 private sleep study. Regarding the in-service element of a service connection claim, the Board finds that service treatment records do not document complaints, treatment, or diagnosis of sleep apnea. A July 1981 enlistment examination documents a normal relevant clinical evaluation, with no sleep apnea noted under defects/diagnoses; additionally, the Veteran denied frequent trouble sleeping within a concurrent report of medical history at enlistment. Upon commission examination in July 1983, a physical examination was again normal, without relevant defects or diagnoses, and the Veteran again denied frequent trouble sleeping within a concurrent report of medical history. In January 1989, the Veteran reported getting little sleep due to long hours at work and was assessed with stress. The following month, the Veteran requested medication for a nervous stomach and insomnia due to increased stress regarding his job and domestic problems; this was assessed as an acute stress reaction secondary to domestic problems. In a November 1990 service treatment record, the Veteran reported he was having “sleep problems.” The examiner wrote that this was a reflection of a recent divorce. Upon separation examination in October 1991, a physical examination was again normal, without relevant defects or diagnoses; although the Veteran reported frequent trouble sleeping within a concurrent report of medical history, a doctor’s notation clarified that the Veteran’s frequent trouble sleeping was due to stress and depression secondary to his divorce in 1990. Thus, while the Veteran complained of trouble sleeping in service, the Board finds that the facts do not support that such was related to sleep apnea or symptoms of sleep apnea, as examiners attributed it to stress and depression. Regarding the third element of a service connection claim, the Board finds that the preponderance of the evidence is against evidence of a nexus between the Veteran’s current sleep apnea and his active service. At the August 2014 VA sleep apnea examination, the Veteran reported that he first began experiencing trouble sleeping in the late 1980s and early 1990s. He reported that his brother visited him at Warren Air Force Base at that time and made a videotape of the Veteran snoring and fighting for breath. The Veteran further stated that, at the time, he attributed his difficulty sleeping to the trauma of witnessing the suicide of another soldier that he counseled as an Air Force chaplain. He noted that at the time, he was sleeping only for six hours a night, and had difficulty staying asleep, as well as daytime fatigue. The Veteran stated that he was hospitalized for a mental evaluation in 1988 and was told at the time that he likely had sleep apnea. Following the examination, the VA examiner opined that the Veteran’s sleep apnea was less likely than not incurred in or caused active service, as there was insufficient evidence within service treatment records to be classified as sleep apnea, and the Veteran’s reports of decreased sleep at that time could be from any number of causes. The Board finds that the August 2013 negative nexus opinion is probative evidence which weighs against the Veteran’s claim. Moreover, there are no positive nexus opinions of record to weigh against the August 2013 negative nexus opinion. The Veteran’s statement to the August 2014 VA examiner that he was told in 1988 that he likely had sleep apnea is not supported by the service treatment records. Additionally, the Board has also considered the Veteran’s lay statements of record regarding his observable symptoms, such as difficulty sleeping during active service, which are probative evidence. However, to the extent such statements assert that the Veteran’s current sleep apnea is related to his active service, such statements are of little probative value given the Veteran’s lack of related medical expertise. Moreover, to the extent that the Veteran asserts that his sleep apnea first had its onset during active service and has continued since that time, such statements are inconsistent with the additional evidence of record, including service treatment records and post-service VA treatment records, which fail to document sleep apnea during active service or soon after service discharge. In fact, there is an April 2011 VA treatment record where he is seen for psychiatric symptoms, and the examiner noted the Veteran’s sleep pattern, which was that the Veteran slept in two-to-three-hour increments and would get up to check the baby and the four year old. The examiner wrote, “He doesn’t know if he snores.” This tends to show that the Veteran was not reporting symptoms indicative of sleep apnea almost 20 years after service discharge. Thus, the Veteran’s allegation that his brother recorded him snoring and gasping for breath while he was in service is not credible. This is further supported by the service treatment records, as there are hundreds of pages of such records, with the Veteran consistently seeking treatment for various medical symptoms, and they do not document the Veteran reporting snoring or gasping for breath. Notably, the Veteran’s documented lay reports of trouble sleeping during active service were consistently related to life stressors, with no mention of sleep apnea or related symptoms. At the time the Veteran was examined in 1992 for a psychiatric disorder, he complained of insomnia, which was attributed to the Veteran being stressed out. In January 2013, when the Veteran was seen at VA, the examiner noted that the Veteran’s primary complaints at that time were snoring, apneic wakening, and daytime fatigue, and the examiner noted was “[v]ery likely” sleep apnea. At that point, the Veteran underwent a sleep study and was diagnosed with sleep apnea. The Veteran’s report of symptoms related to sleep apnea in January 2013 is approximately 20 years following service discharge and tends to show that such disability did not have its onset in service. In conclusion, the preponderance of the evidence of record weighs against the Veteran’s claim of entitlement to service connection for sleep apnea. As the preponderance of the evidence is against the Veteran’s claim, there is no reasonable doubt to be resolved, and the claim is denied. A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Chad Johnson, Counsel