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Evidence checklist

Central Sleep Apnea

DC 684738 CFR § 4.97Respiratory

Evidence strength

Mark what you already have below and your evidence strength appears here.

Target
Saved locally
01

Specialist opinion

Highest value0 of 2 collected
Sleep study (polysomnography) confirming central apnea eventsCritical

In-lab polysomnography (PSG) documenting central apnea events (absent respiratory effort with airflow cessation), AHI, and the proportion of central vs. obstructive events. Home sleep tests are insufficient for CSA diagnosis.

Private provider · independent opinion
Nexus opinion linking central sleep apnea to service or service-connected conditionCritical

A medical opinion connecting CSA to a service-connected condition such as TBI, brainstem injury, opioid use for service-connected pain, PTSD, or congestive heart failure secondary to a service-connected cardiac condition.

Private provider · independent opinion
02

Treating physician

0 of 1 collected
Cardiac evaluation if Cheyne-Stokes breathing or heart failure is the cause

Records from cardiology evaluation if the CSA occurs in the context of heart failure with Cheyne-Stokes respiration, documenting the cardiac etiology and its service-connected basis.

Your treating provider · written request
03

Treatment records

0 of 2 collected
PAP therapy prescription and compliance records (CPAP, BiPAP, or ASV)Critical

Documentation that positive airway pressure therapy has been prescribed and compliance data from the PAP device. Prescription of PAP therapy is the threshold for the 50% rating under 38 CFR § 4.97.

VA or private records · written request
Documentation of persistent daytime sleepiness (Epworth Sleepiness Scale)

Epworth Sleepiness Scale results or treating physician documentation of hypersomnolence not resolved by PAP therapy, which may support a higher rating or additional functional impairment documentation.

VA or private records · written request
04

Lay statements

0 of 2 collected
Buddy statement from spouse, family, or fellow service member

A statement from a spouse or roommate describing witnessed apnea episodes, gasping, nighttime awakenings, and daytime fatigue caused by central sleep apnea.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

You or a witness · VA Form 21-4138 or 21-10210How to get this →
05

Benefits questionnaire

0 of 1 collected
Completed DBQ Sleep ApneaCritical

Standardized form capturing sleep study results, PAP therapy requirements, and daytime symptoms of central sleep apnea.

Provider-completed · VA DBQ formHow to get this →
06

Service records

0 of 2 collected
TBI or brainstem injury records (if applicable)

Military records or medical documentation of traumatic brain injury, blast exposure, or other neurological injury affecting brainstem respiratory control as the underlying cause of CSA.

NPRC / milConnect · SF-180
Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.

NPRC / milConnect · SF-180
Condition guideRating criteria and what VA looks forBuddy statement builderGuided VA Form 21-10210

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