Citation Nr: 20006548 Decision Date: 01/27/20 Archive Date: 01/27/20 DOCKET NO. 15-38 067 DATE: January 27, 2020 ORDER Service connection for sleep apnea is denied. FINDING OF FACT The Veteran’s current sleep apnea was not manifest in service, is unrelated to service, and was not caused or aggravated by a service connected disability. CONCLUSION OF LAW The criteria for service connection for sleep apnea have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1995 to August 1999 and from February 2000 to March 2004. He has contended that his sleep apnea is secondary to his service connected major depressive disorder and/or migraine headaches.   Establishing service connection generally requires medical or, in certain circumstances, lay evidence of: (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313 (Fed.Cir.2009); Hickson v. West, 12 Vet. App. 247, 253 (1999); Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F.3d 604 (Fed.Cir.1996) (table). Service connection may be granted, on a secondary basis, for a disability which is proximately due to, or the result of an established service-connected disorder. 38 C.F.R. § 3.310. Similarly, any increase in severity of a non-service connected disease or injury that is proximately due to or the result of a service connected disease or injury, and not due to the natural progress of the nonservice connected disease, will be service connected. Allen v. Brown, 7 Vet. App. 439 (1995). In the latter instance, the non-service connected disease or injury is said to have been aggravated by the service-connected disease or injury. 38 C.F.R. § 3.310. The Veteran's current sleep apnea disability was diagnosed following an August 2010 sleep study. The Veteran denied having sleep problems on service examination in July 1999. Just prior to an August 2010 sleep study showing sleep apnea, also in August 2010, the Veteran had reported loud snoring, and his wife reported apneic spells, and it was felt he might have sleep apnea, and so a polysomnogram (sleep study) was ordered. The preponderance of the evidence is against a finding that sleep apnea was manifest in service, or is related to service, or was caused or aggravated by a service connected disability. A VA examiner indicated in August 2015 that it is less likely than not proximately due to or the result of the Veteran’s service connected major depressive disorder and/or migraine headaches disorder. The rationales included that while there is a higher incidence of depression in people diagnosed with sleep apnea, the prevailing theory is that diminished oxygen from the brain and interrupted sleep due to sleep apnea causes depression. In other words, it appears that sleep apnea can cause depression, but not that depression can cause or aggravate sleep apnea. The examiner indicated that it is unlikely that the Veteran’s migraine headaches, triggered by light and smells, are associated with his sleep apnea, and there is no evidence in the medical literature to indicate that sleep apnea is caused by headaches. The Veteran was scheduled for three VA examinations to specifically address the matter of aggravation by the service connected disabilities following an August 2018 Board remand directing the same, but he failed to report for them. He advised VA in June 2019 that he has been out of the country and requested rescheduling. After the second attempt, he advised VA in July 2019 that he had not received the letter about the appointment until 3 days after the appointment had passed. Thereafter, the Veteran failed to report to a third scheduled examination. He did not correspond thereafter with VA with any reason for his failure to report including after receiving his October 2019 supplemental statement of the case. Accordinly, the Board finds VA’s duty to assist in this regard has been satisfied. While the Veteran may feel that his sleep apnea is secondary to his service connected major depressive disorder and/or migraines, he is not competent to provide an opinion as to this complex medical matter, as he is a layperson and this medical subject matter is beyond his qualifications as a layperson. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). The preponderance of the evidence is against the claim and there is no reasonable doubt to be resolved in the Veteran’s favor to permit an allowance of the claim. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1991). M. C. GRAHAM Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Lawson The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.