Citation Nr: 20021132 Decision Date: 03/24/20 Archive Date: 03/24/20 DOCKET NO. 18-17 721 DATE: March 24, 2020 ORDER Entitlement to service connection for obstructive sleep apnea is denied. FINDING OF FACT The record evidence shows that the Veteran’s obstructive sleep apnea is not related to active service. CONCLUSION OF LAW The criteria for service connection for obstructive sleep apnea have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.303, 3.304 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the U.S. Navy from March 1993 to March 2013, to include service in the Gulf War. The Veteran contends that he has obstructive sleep apnea (which he characterized as a sleep disorder) which is related to active service. A review of the Veteran's service treatment records (STRs) indicate that he did not endorse any sleep problems in his March 1992 Report of Medical History (entrance exam) and did not indicate that he experienced “frequent trouble sleeping” on the questionnaire. Additionally, the Veteran asserted that he was in “perfect” health and not taking any medication at the time of his induction. Nevertheless, there are indications that the Veteran had trouble sleeping in service. In a Sleep Apnea Disability Benefits Questionnaire (DBQ) dated in August 2014, the Veteran disclosed that his symptoms of a sleep disorder were first witnessed by his first wife in 2001. The Veteran stated that he often woke up during the night. The Veteran also reported that he experienced frequent trouble sleeping on his December 2012 Report of Medical History. This report indicates that, in October of 2011, the Veteran underwent a sleep study. The Veteran complained of waking up at night frequently and feeling tired during the day. He also complained of gasping when awakened. The attending physician noted that the sleep study was normal and not suggestive of obstructive sleep apnea. A May 2013 exam similarly indicated that he did not have obstructive sleep apnea. The VA examiner reviewed the Veteran’s electronic claims file, including his service treatment records and post-service VA treatment records. The VA examiner concluded that the Veteran did not suffer from obstructive sleep apnea or even manifest any symptoms attributable to obstructive sleep apnea. The Veteran presented to a second sleep study in May 2014 when was diagnosed with “mild obstructive sleep apnea syndrome.” In September 2014, continuous positive airway pressure (CPAP) therapy was recommended. There was no nexus opinion provided by the attending physician as to the cause of the Veteran’s obstructive sleep apnea. In March 2015, a VA examiner reviewed the Veteran’s file. After reviewing all relevant medical evidence of record, the VA examiner noted that while the Veteran suffered from a current sleep disorder, it was less likely than not incurred in or caused by the Veteran’s military service. The VA examiner acknowledged that while the Veteran experienced snoring and other sleep disturbances while in service, the October 2011 sleep study results did not support a diagnosis of obstructive sleep apnea. Instead, the VA examiner emphasized that medical conditions are “dynamic,” and conceded that with time the Veteran could surely develop sleep apnea; however, he concluded that the Veteran did not have obstructive sleep apnea during service. The Veteran has a well-documented history of sleeping problems while in service; however, there is no medical opinion of record linking his current obstructive sleep apnea to service. The Veteran is competent to report that he has trouble sleeping. His lay statements alone do not establish a nexus to service, however, because he is not shown to have the expertise or medical knowledge to provide a medical opinion regarding etiology. The issue is medically complex as it requires knowledge of the interpretation of complicated diagnostic medical testing (polysomnography). See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Although the Veteran experienced trouble sleeping during service, the October 2011 sleep study and additional contemporaneous records establish that obstructive sleep apnea first manifested after service. These records are more probative and credible than the Veteran’s lay assertions. While the Veteran has a current diagnosis of obstructive sleep apnea, and he reported insomnia and difficulty sleeping in service, the preponderance of the evidence weighs against finding that obstructive sleep apnea began during service or otherwise is related to service. The Veteran finally has not identified or submitted any evidence demonstrating his entitlement to service connection for obstructive sleep apnea. In summary, the Board finds that service connection for obstructive sleep apnea is not warranted. MICHAEL T. OSBORNE Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Harrell 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. MICHAEL T. OSBORNE Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Harrell 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.