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Sleep Apnea and the Military

This area is for Sleep Apnea questions and general Sleep Apnea Discussions.


Postby superslacker87 » Sat May 08, 2010 12:21 pm

Hey guys, I just thought I'd let you know. As of May 5, most of us are deployable again. CENTCOM updated the deployment policy from MOD 9 to MOD 10 and OSA is specified in the appendix. The text is as follows:

10. Obstructive sleep apnea (OSA). The OSA should be documented/diagnosed with in-laboratory polysomnography, with a minimum of 2 hours of total sleep time, that yields an apnea-hypopnea index (AHI), or respiratory disturbance index (RDI), of greater than 5 / hour. Individuals who are treated with continuous positive airway pressure (CPAP) should deploy with a machine that has rechargeable battery back-up and sufficient supplies for the duration of the deployment. Individuals deploying to a location where their sleep environment has unfiltered air will typically not be granted waivers if a waiver is required per the guidance below. Advanced modes of airway pressure (adapt-servo ventilation, BIPAP, etc.) are not permitted in theater. The following guidelines are designed to ensure that individuals with OSA are adequately treated and that their condition is not of the severity that would pose a safety risk should they be required to go without their CPAP for a significant length of time.
a. Symptomatic OSA of any severity is non-deployable. No waivers granted. b. Mild (apnea-hypopnea index, AHI, < 15/hr) OSA with or without continuous positive airway pressure (CPAP) treatment is deployable, no waiver required.
c. Untreated moderate to severe (AHI ≥ 15/hr) OSA is non-deployable. No waivers granted.
d. Treated (CPAP or otherwise) OSA with an AHI < 30/hr does NOT require a waiver to deploy, except to Afghanistan or Yemen.
e. Treated OSA with an AHI ≥ 30/hr requires a waiver for deployment to any location in the AOR.
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Postby SGT.McLain » Fri Aug 13, 2010 8:47 pm

I have just been recently diagnosed with Severe OSA and CSA. I was wondering if I would be non deployable. I was Medevac'd from the Centcom AOR in November of 2009 due to torn cartilage both shoulders. I have been since undergoing treatment for my shoulders. I was also diagnosed with PTSD. I guess my question is will I be able to stay in the military for one, for two if I am able to REFRAD will I be able to deploy? If I am forced to retire by a MEB what compensation will I receive from the military. I am a E5 in the reserves and have been in 4 years. Any help here would be greatly appreciated, Thank you.
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Postby dogwoodlover » Thu Aug 19, 2010 3:52 am

This is probably not the best place to ask, but admittedly I'm having difficulty finding someone who can give me an answer (besides going to a recruiter and having them see if I can get waivered).

I was diagnosed with very Mild OSA a couple years ago, with my numbers being low enough to not qualify with insurance for a CPAP. I don't remember much of the data, but I think the number of awakenings per hour was something less than 10, my blood oxygenation looked fairly good, and I think my overall score (sorry, I know that isn't the correct term, but I only looked at the data once) was a 5. Basically the verdict was that my sleep apnea wasn't bad at all, but it was enough to interfere with my life (never being able to wake up, always feeling tired when I did).

I went to an ENT who examined me and decided to go the surgery route. I ended up having a turbinoplasty, septoplasty, and a tonsillectomy. After recovering, I found that my sleep had improved markedly, the point where I no longer feel as if I have any sleep disorders (prior to, sleeping was absolute hell for me). I now can go to sleep normally (no more overcaffeinating to compensate for the SA, which of course caused bad insomnia) and I feel good when I wake up from sleeping for eight hours (previously, I could sleep for 10 and still feel horrible).

I've also been dieting to reduce body fat, and I've been steadily losing weight. Personally, I feel like the surgery combined with diet and consistent sleep patterns has "cured" my OSA. I'm in decent shape, and I'm hoping to be able to get a SEAL contract with the Navy once I get my PST scores up to par for BUD/S. I am planning to schedule another sleep study to see how much my OSA has improved, and I'm hoping that my doctor will decide that I no longer have OSA... though I have a feeling she won't want to declare me "cured", but just "improved".

Does anyone here have any idea how difficult/likely it would be to get a medical waiver for enlisting with MOSA? By the time I am ready to get the enlistment process underway, I plan to be pulling stellar PST scores (my calisthenics are already around 80 pushups/20+ pullups/80 situps, and I plan to keep improving them) to demonstrate my fitness for BUD/S and the lack of impact OSA has had on my fitness, plus I hope the fact that I don't need/use a CPAP will also help me get waivered.

Thanks for any feedback.
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Postby tokyo43 » Sat Aug 21, 2010 11:54 am

Good information in this thread, but also tons of misinformation and also outdated information.

I'll post my experience for whatever it's worth.

AD USAF stationed in Japan. Was referred to an off-base sleep clinic in 2009. Completed the sleep study. 26 AHI per hr. Once my military doc received the report (mild OSA) he wrote a prescription for a CPAP - pressure setting of 5. Tricare sent the prescription to a civilian medical supply company and they shipped an Everest (preset to 5) with humidifier and nasal mask directly to my APO box. I figured out how to use the cpap and adjust the mask by reading the instructions. There was a bill in the box for a outrageous overcharge to the taxpayers (via tricare), but that's another story. That was about a year ago. Every quarter the medical company sends me an email asking if I need resupplied. When they send me these emails I use it as an opportunity to request other things I want. So far I have tried 3 different masks (including the original mask) and also had them send me a chin strap. They won't let me pick the brand/model so I may switch to another Tricare equipment provider.

A couple of tips for Active duty.

First off some of you need to man-up. It's your life. If you're a NCO or above you should know how to take charge and deal with bureaucracies.

If you're not getting the equipment you need get a copy of your prescription, email it to a tricare equipment provider, and then call the company and tell them what you need. They will send it to you and bill it to tricare. If they aren't helpful try a different company. That's how I got the backup battery for my Everest machine.

If they still won't give you the equipment you need go back to your doc and ask him to amend your prescription. i.e. requires nasal pillow mask, or backup battery, or whatever.

It's critical for your VA disability rating that your sleep apnea is diagnosed while still on active duty (if your retiring tomorrow I would go the clinic today and request medical hold until the sleep study is complete). Also critical that the paperwork isn't lost. Ask your clinic to give you copies of your sleep study and doctor prescription, preferably certified with their stamp/signature. Don't take a chance on your medical record getting lost. Much easier to get copies now.

Regarding VA disability I have a copy of the regulation and it states plain as day that sleep apnea requiring use of CPAP is 50% disabled. End of story. There is no doctor/VA discretion. Either you have a sleep study/prescription specifying CPAP or you don't. Understand that the disability pay isn't an additional 50% of your base pay. It's actually a set amount for all ranks based on the disability rating and # of dependents. Google it.

Those of you guys needing equipment in the field. Have the medical company send the equipment to your family or unit. If you can't figure out how to get it downrange from there you got issues.

Don't use this as an excuse to get out of a deployment. That's BS. Be proactive/aggressive so you don't deploy without your equipment and supplies, but don't pull any whiny I can't go BS. If day to day you're way less than 100% alert let your chain that your chronic sleep depredation makes you prone to mental errors, memory loss, vehicle crashes, fratricide, etc, until it's sorted out. Proven medical fact. Follow up with a letter or email to your CC and doctor for CYA. Again time to man-up.

I have not been through the MEB process yet, but talking to several docs and numerous OSA individuals I have not heard of a single person being separated from the AF. Doc says the MEB will be fast-tracked and that it's just a formality. I would guess however if you have other issues (I don't) OHA could break the camels back.

Any questions send me a PM.
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Postby tokyo43 » Sat Aug 21, 2010 12:23 pm

tokyo43 wrote:Good information in this thread, but also tons of misinformation and also outdated information.

I'll post my experience for whatever it's worth.

AD USAF stationed in Japan. Was referred to an off-base sleep clinic in 2009. Completed the sleep study. 26 AHI per hr. Once my military doc received the report (mild OSA) he wrote a prescription for a CPAP - pressure setting of 5. Tricare sent the prescription to a civilian medical supply company and they shipped an Everest (preset to 5) with humidifier and nasal mask directly to my APO box. I figured out how to use the cpap and adjust the mask by reading the instructions. There was a bill in the box for a outrageous overcharge to the taxpayers (via tricare), but that's another story. That was about a year ago. Every quarter the medical company sends me an email asking if I need resupplied. When they send me these emails I use it as an opportunity to request other things I want. So far I have tried 3 different masks (including the original mask) and also had them send me a chin strap. They won't let me pick the brand/model so I may switch to another Tricare equipment provider.

A couple of tips for Active duty.

First off some of you need to man-up. It's your life. If you're a NCO or above you should know how to take charge and deal with bureaucracies.

If you're not getting the equipment you need get a copy of your prescription, email it to a tricare equipment provider, and then call the company and tell them what you need. They will send it to you and bill it to tricare. If they aren't helpful try a different company. That's how I got the backup battery for my Everest machine.

If they still won't give you the equipment you need go back to your doc and ask him to amend your prescription. i.e. requires nasal pillow mask, or backup battery, or whatever.

It's critical for your VA disability rating that your sleep apnea is diagnosed while still on active duty (if your retiring tomorrow I would go the clinic today and request medical hold until the sleep study is complete). Also critical that the paperwork isn't lost. Ask your clinic to give you copies of your sleep study and doctor prescription, preferably certified with their stamp/signature. Don't take a chance on your medical record getting lost. Much easier to get copies now.

Regarding VA disability I have a copy of the regulation and it states plain as day that sleep apnea requiring use of CPAP is 50% disabled. End of story. There is no doctor/VA discretion. Either you have a sleep study/prescription specifying CPAP or you don't. Understand that the disability pay isn't an additional 50% of your base pay. It's actually a set amount for all ranks based on the disability rating and # of dependents. Google it.

Those of you guys needing equipment in the field. Have the medical company send the equipment to your family or unit. If you can't figure out how to get it downrange from there you got issues.

Don't use this as an excuse to get out of a deployment. That's BS. Be proactive/aggressive so you don't deploy without your equipment and supplies, but don't pull any whiny I can't go BS. If day to day you're way less than 100% alert your chain that your chronic sleep depredation makes you prone to mental errors, memory loss, vehicle crashes, fratricide, etc, until it's sorted out. Proven medical fact. Follow up with a letter or email to your CC and doctor for CYA. Again time to man-up.

I have not been through the MEB process yet, but talking to several docs and numerous OSA individuals I have not heard of a single person being separated from the AF for many years. Doc says the MEB will be fast-tracked and that it's just a formality. I would guess however if you have other issues (I don't) OHA could break the camels back.

Any questions send me a PM.
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Postby orly » Wed Sep 01, 2010 1:51 pm

Hello, I am a AF Reserve member that was Active Duty from 95-99 and then activated from 01-02, 03-04, then off and on totaling 8yrs AD and 6 with the Reserves 14yrs total. I was diagnosed with sleep apnea while on AD orders that started Jul09 to present and dianosed Sep09. I was denied in the Line of Duty becuase i didn't have any complaints in my SMR's, but now i'm wondering how to prove that OSA started when i was AD. The docotor stated on the LOD that it was a prior existing so he claimed "approved LOD for service aggravated". It got to the JAG office and they denied it. I was given a waiver to stay in the Reserves and was able to deploy 09-10 to Iraq. I have had the symptoms all along, but never thought to complain about them especially since the medical questionaires never had questions about day time sleepiness and snoring I didn't know about OSA until my girlfriend said something becuase her mom has it. The only thing that is in my records is that I have a broken nose with no problems and I weighed 179 when i jonined and 220 when i was diagnosed. How could i prove a nexus to show that it began in service. I'm wondering if I should go to the VA and what would be my chances of getting approved. I'm going to my private doctor who is a family practice doctor to see if he could help write a statement. I also plan to get buddy statements whilie i was deployed. Please Help.
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Postby tokyo43 » Thu Sep 02, 2010 10:15 pm

Why didn't you see the doc earlier?

Did legal give any justification/legal reference for the denial?
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Deploying

Postby bmcm2ret » Fri Sep 03, 2010 7:35 am

I am a DOD civilian scheduled to deploy to either Iraq or Afghanistan on 01 Oct 2010. I have completed all physical requirements but the only thing I'm waiting on right now is results of a waiver request for OSA. I was diagnosed back in 2003 the year before I retired from the military. Since then, I've used my machine religiously each night (with the exception of occasional power outages due to inclement weather). I recently had to have a new consult for a sleep study which the doctor endorsed favorably indicating a new sleep study was not necessary. All paperwork submitted as requested. I have a battery backup and all supplies for my RESMED 8 machine standing by to go. My question is: Can someone tell me how long, generally, it takes CENTCOM to make a decision on the waiver? Thanks.
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Statement from Dr. concerning SLEEP APNEA

Postby theprimitivemind » Wed Sep 15, 2010 12:04 am

Would a statement like this be good enough to get approved for VA disability for Sleep Apnea?

Joe Blow is being treated by me for OSA. I have reviewed his service medical and treatment records, and I believe that it is more likely than not, that he suffered from OSA while serving on active duty in the military. Please feel free to contact me with any questions.


Sincerely,


Dr. Compassionate
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Re: Sleep Apnea compensation for non retirees

Postby theprimitivemind » Wed Sep 15, 2010 11:59 am

Anonymous wrote:I claimed sleep apnea as a disability and was turned down, and I had my nose broken while active duty. I am wanting to appeal. I am already 50% with knees and hearing. I did not retire so I am looking for other disabled vets who did not retire that got compensation for sleep apnea. I know I had the sleep apnea while active duty, but was not tested. I got out of the Army in 1988, so discharge procedures were alot different then than now.


You need a statement from a private physician stating "Joe Blow is being treated by me for OSA. I have reviewed his service medical and treatment records and I believe that it is more likely than not, that he suffered from OSA while serving on active duty in the military."
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Re: Sleep Apnea compensation for non retirees

Postby BGSMSHR » Wed Sep 15, 2010 10:09 pm

theprimitivemind wrote:
Anonymous wrote:I claimed sleep apnea as a disability and was turned down, and I had my nose broken while active duty. I am wanting to appeal. I am already 50% with knees and hearing. I did not retire so I am looking for other disabled vets who did not retire that got compensation for sleep apnea. I know I had the sleep apnea while active duty, but was not tested. I got out of the Army in 1988, so discharge procedures were alot different then than now.


You need a statement from a private physician stating "Joe Blow is being treated by me for OSA. I have reviewed his service medical and treatment records and I believe that it is more likely than not, that he suffered from OSA while serving on active duty in the military."


And you need it written while on active duty. A doctor after the fact can not tell the VA you had sleep apnea last year, for example.
RemStar Pro M-Series with C-Flex jamming 10 cm H20 down my piehole :shock: And finally getting a good night's sleep...every night!!!! I'm a 46 year old FMAWG...and proud of it.
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Postby lisabird83 » Tue Oct 19, 2010 2:00 pm

Hi there. my husband is going through the same exact issue. He was in the meb process and preparing to leave the army with 50% disability. Then suddenly he is able to RTD and deploy? I dont understand this. If that is the way it was going to be, why did they put him in WTU and go through the MEB process for the past 6 months only to tell him he is deploying? why couldnt they just give him his cpap and deploy him instead of putting us through all this grief?

I have called my congressmen because we have no where else to turn. Does anyone else know if you can go to afghanistan as an infantryman with severe obstructive sleep apnea?
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Severe Obstructive Sleep Apnea

Postby angmsgt » Sat Oct 23, 2010 3:30 pm

Hi, I just got diagnosed with severe obstructive sleep apnea a month ago. I am in the Air National Guard part time and work as a technician fulltime on the base. I must maintain my military affiliation to keep my civilian position. i was diagnosed as severe primarily because my oxygen level dropped to 79% when i sleep. I am looking for them to MEB me soon and really want them to save that i am unfit because then i will also receive my disability for my civilian position as well. i have to get another letter from my doctor this month and he says that i am not capable of deploying to an auster environment with my oxygen levels dropping. He says that i could suffer from organ damage, heart failure, stroke, or even sudden death sydrome with that low of an oxygen level. does anyone have any suggestions on what i should do.
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Re: Severe Obstructive Sleep Apnea

Postby pamunkey » Sat Oct 30, 2010 2:56 am

angmsgt wrote:Hi, I just got diagnosed with severe obstructive sleep apnea a month ago. I am in the Air National Guard part time and work as a technician fulltime on the base. I must maintain my military affiliation to keep my civilian position. i was diagnosed as severe primarily because my oxygen level dropped to 79% when i sleep. I am looking for them to MEB me soon and really want them to save that i am unfit because then i will also receive my disability for my civilian position as well. i have to get another letter from my doctor this month and he says that i am not capable of deploying to an auster environment with my oxygen levels dropping. He says that i could suffer from organ damage, heart failure, stroke, or even sudden death sydrome with that low of an oxygen level. does anyone have any suggestions on what i should do.


Sounds like you are doing all you can right now. As you may be aware, the ANG medical processing is somewhat different than AD. ANG does a world-wide deployment assessment which it sounds like you won't pass. A waiver to this is possible, but unlike AD, unlikely in the ANG. The reason I have heard for the difference is that, unlike AD and their provided medical care, ANG has no ability to ensure that you continue with medical care with your civilian doctor. Once considered non-world-wide deployable, the next question is if you are sitting in a deployable position on your unit manning document. Because almost all ANG manning documents are built against deployment positions, you probably are. The next step is most likely military discharge followed by administrative loss of your technician job due to failure to maintain military membership. As a MSgt you probably have more than 20 years so expect a standard military retirement which may still say something about medical, not sure. But as ANG, you won't be drawing your military retirement until 60 anyway. Because of the roundabout way you lost your civilian technican job, you can apply for civilian disability. You can also apply to the VA for disability to see what you can get but it is not exactly the same as an AD member with apnea. I am in a slightly different position than you. I was an ANG technician diagnosed in 2007 with apnea. I didn't want to lose my technician job so I never told the ANG I had apnea. This summer I left the technican force with 23 years total technican time, 29 years total federal civilian service, and 32 years total military, to take another federal civilian job. Once I was just a typical ANG weekender, I told the ANG about the apnea and am starting the review process. I just learned that my doc considers my apnea to be severe and like you, he could not provide me with the justification letter needed for a waiver. I may be moved into one of the few positions that are not considered deployable (State HQ) and may end up staying a few more years. After 32 years in the military and a Chief for the last 6, I really don't care one way or another if I stay. Best of luck to you.
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New militry deployment guidelines for OSA

Postby Vicki » Sun Mar 13, 2011 2:51 am

Being defeated is often a temporary condition. Giving up is what makes it permanent.
Marilyn Vos Savant

That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.
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