Citation Nr: 21074000 Decision Date: 12/13/21 Archive Date: 12/13/21 DOCKET NO. 17-12 415 DATE: December 13, 2021 ORDER Entitlement to service connection for a sleep disorder (claimed as sleep apnea), to include as secondary to service-connected disabilities, is denied. FINDING OF FACT The Veteran's sleep disorder is not shown to be causally or etiologically related to any disease, injury, or incident in-service, or caused or aggravated beyond the natural progression by the service-connected posttraumatic stress disorder (PTSD), headaches, and tinnitus. CONCLUSION OF LAW The criteria to establish service connection for a sleep disorder, to include as secondary to the Veteran's service-connected disabilities, are not met. 38 U.S.C. §§ 1101, 1131, 1154, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1981 through December 1985. This matter comes before the Board of Veterans' Appeals (BVA or Board) on appeal from a June 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In February and June 2021, the Board remanded these matters to the Agency of Original Jurisdiction (AOJ) for additional development. The appeal has since returned to the Board. 1. Entitlement to service connection for a sleep disorder, to include as secondary to service-connected disabilities, is denied. The Veteran contends that his sleep disorder is related to his service. Alternatively, he alleged that his service-connected disabilities caused or aggravated his sleep disorder. Generally, service connection requires evidence of (1) a current disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a nexus, or link, between the current disability and the in-service disease or injury. 38 C.F.R. § 3.303(a). Alternatively, secondary service connection may be granted for a disability that is proximately due to, the result of, or aggravated by, a service-connected disease or injury. 38 C.F.R. § 3.310. Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists, (2) an already service-connected disability, and (3) that the disability for which secondary service connection is sought was either (a) caused or (b) aggravated by the already service-connected disability. See Allen v. Brown, 7 Vet. App. 439 (1995). The record contains a current diagnosis of a sleep disorder, sleep apnea. See August 2021 C&P examination. Thus, the first element for establishing service connection has been satisfied. The remaining questions before the Board are whether there was an in-service incurrence of a disease or injury; and whether the current disability is related to an in-service incurrence, if any. Service treatment records are silent for treatment, complaints, or diagnoses related to a sleep disorder. Likewise, the Veteran's entrance examination is silent for a sleep disorder. His separation examination could not be located. In July 2019, the Veteran was afforded a VA examination for his sleep disorder. He reported that his sleep disorder began in 1985 and was described as insomnia secondary to stress. He stated that he never formally presented for treatment, nor reported the disability, while he was in active service. The examiner opined that the Veteran's sleep disorder was less likely than not related to his active service. The examiner explained that the Veteran's claimed sleep disorder is a symptom of his service-connected PTSD and does not meet the criteria for a separate diagnosis. Later in July 2019, a sleep study confirmed a diagnosis of obstructive sleep apnea. In August 2021, the Veteran was afforded another VA examination. After reviewing the record and interviewing the Veteran, the examiner opined that it is less likely than not that his sleep disorder was related to his in-service injury, event, or disease. The examiner explained that the medical record did not reveal continuous, ongoing medical treatment or aggravation of a sleep apnea condition during the time of discharge from activity military to present day. Additionally, the examiner opined that it is less likely than not that the Veteran's sleep disorder was caused or aggravated by his service-connected disabilities. It was explained that sleep apnea is caused by dynamic narrowing of the upper airways. Such closure of the oral pharynx during sleep is not caused by a PTSD and anxiety disorder, tinnitus, and/or headaches. Considering the aforementioned, service connection for the Veteran's sleep disorder is not warranted. The medical evidence is in agreement against finding a nexus to service, or that his sleep disorder was caused or aggravated by his service-connected disabilities. The Board finds the etiological and aggravation opinions are highly probative as the examiners considered the entirety of the available record, considered the lay statements of record, conducted in-person interviews with the Veteran, and submitted competent and adequate explanations for opinions expressed. To the extent that the Veteran seeks service connection for insomnia or sleep disturbances due to nightmares, the preponderance of the evidence supports that the Veteran is already compensated for such in the award of service connection for PTSD. The July 2019 VA opinion supports that the Veteran is not entitled to separate disability for insomnia. As discussed above, the July 2019 VA opinion is highly probative and there is no competent evidence to the contrary. As the preponderance of the evidence is against finding that the sleep disorder is related to service, or is proximately caused or aggravated by his service-connected disabilities, his claim for service connection for a sleep disorder, under direct and secondary theories, is denied. B. G. LeMoine Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N.B. Mmeje, Associate Counsel 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.