Linking Sleep Apnea To Back Pain

Back pain is one of the VA’s most common disability awards. What many veterans don’t realize is that chronic back problems—especially in the thoracic or lumbar spine—can set the stage for sleep apnea, a condition where breathing repeatedly stops during the night. If your back is already service connected and you now struggle with sleep apnea, you may be entitled to a secondary service connection and separate compensation.

Below, our friends from Gregory M. Rada, Attorney at Law discuss linking sleep apnea to back pain.

Why Back Problems Can Trigger Sleep Apnea

Injuries or degeneration in the mid to lower spine can disrupt the nerves and muscles that keep your airway open. Pain-related weight gain, poor posture, and even the sedating medications prescribed for back pain can all narrow or weaken the airway, causing the tongue and throat tissues to collapse during sleep. Medical literature—cited by the American Academy of Sleep Medicine—recommends screening spinal injury patients for disordered breathing for exactly this reason. A growing body of research also shows that chronic opioid use, common in severe back cases, depresses respiratory drive and worsens oxygen saturation at night.

To Win A Secondary Claim, You Must Check Three Boxes

1. A current diagnosis of obstructive, central, or mixed sleep apnea confirmed by a sleep study (polysomnography).

2. Proof your back condition is already service connected.

3. A nexus opinion from a qualified clinician stating it is “at least as likely as not” that your back condition—or the treatment for it—caused or aggravated your sleep apnea.

Building Strong Evidence By Stacking Your File With The Following

• The full sleep-study report and CPAP/BiPAP prescriptions, including compliance data downloaded from the machine’s memory card.
• Treatment notes linking back-pain flare-ups, mobility limits, or medication changes to worsening sleep symptoms.
• Buddy or spouse statements describing loud snoring, gasping, or daytime fatigue that began after your back issues.
• A timeline showing weight gain or reduced physical activity tied to your spinal condition, if obesity is the “intermediate step.”
• Journal articles or clinical guidelines that discuss the relationship between spinal pathology and upper-airway collapsibility.

Expect Pushback—Here’s How To Respond

VA examiners often say there’s “no direct anatomical link” between lumbar spine disease and upper-airway obstruction. Counter that with peer-reviewed studies or a letter from your treating sleep specialist explaining how spinal injury, pain medications, or postural changes compromise nighttime breathing. If the VA denies your claim, appeal with an independent medical opinion; recent Board decisions show veterans prevail when experts lay out a clear, medically sound rationale. Remember, a secondary sleep-apnea grant typically yields a 50 percent rating if a CPAP is required, so the stakes are high.

Bottom Line

Sleep apnea secondary to a service-connected back disability is real—and compensable. With a documented diagnosis, a strong nexus letter, and supporting statements, you can secure additional monthly benefits and back pay. If you receive a denial, don’t give up; the benefit-of-the-doubt rule can tip the scales when evidence is split. For tailored guidance, consider consulting an accredited representative who understands both spinal conditions and sleep Disorders, as well as a veterans disability lawyer. A well-organized claim today can safeguard your health and your income for years to come.