Citation Nr: 18156514
Decision Date: 12/10/18	Archive Date: 12/10/18

DOCKET NO. 15-40 033
DATE:	December 10, 2018
ORDER
Entitlement to service connection for obstructive sleep apnea is granted.
FINDING OF FACT
The evidence is at least in equipoise as to whether the Veteran’s obstructive sleep apnea had its onset during his active duty service.
CONCLUSION OF LAW
The criteria for entitlement to service connection for obstructive sleep apnea have been met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran served on active duty in the Air Force from June 1990 to June 2011, including service in Southwest Asia.  
Service connection may be granted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in or aggravated by active military service.  See 38 U.S.C. § 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. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)).
The Veteran was first diagnosed with mild obstructive sleep apnea in July 2011, following a VA sleep study conducted just one month after his separation from service.  As the Veteran has a current diagnosis of obstructive sleep apnea, the first element of service connection is met. 
Service treatment records show that in February 2011, the Veteran reported a history of snoring, gasping awake at night, holding his breath while sleeping, and not feeling refreshed upon awakening.  The examiner diagnosed the Veteran with significant sleep dysfunction in need of further evaluation.  The Veteran was also diagnosed with insomnia in service and reported various sleep issues.
Post-service, the Veteran has consistently reported trouble sleeping and not feeling rested in the morning.  He also reported that his former wife, a registered nurse, observed him stop breathing while sleeping.  In addition, his ex-wife submitted a statement claiming that the Veteran only slept for three to four hours per night.  
The Veteran received a VA examination in April 2012.  In an addendum opinion received in January 2013, a VA examiner opined that the Veteran’s obstructive sleep apnea was at least as likely as not related to his military service.  
In consideration of the lay and medical evidence, including the Veteran’s consistent reports of difficulty sleeping while on active duty and the VA medical opinion obtained in January 2013 relating the Veteran’s obstructive sleep apnea to his military service, the Board finds that the evidence is at least in relative equipoise as to whether the Veteran’s obstructive sleep apnea had its onset during his active duty service.  When the evidence for and against the claim is in relative equipoise, by law, the Board must resolve all reasonable doubt in favor of the Veteran.  See 38 U.S.C. §§ 1154 (b); 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990).  Therefore, the benefit of the doubt must be resolved in favor of the Veteran, and entitlement to service connection for obstructive sleep apnea is warranted.

 
P.M. DILORENZO
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J. Freeman, Associate Counsel