How Sinus Issues and Nasal Blockages Can Lead to Sleep Apnea

Many veterans suffer from both upper respiratory conditions—like sinusitis, rhinitis, or a deviated septum—and obstructive sleep apnea (OSA). Research and VA decisions now support a clear connection: chronic nasal problems can play a major role in the development or worsening of sleep apnea.

How This Works

Your upper airway, especially during sleep, is soft and flexible. Because of this, it’s prone to narrowing or collapsing. Sleep apnea happens when soft tissues in the throat collapse and block the airway during sleep, cutting off airflow until the body briefly wakes up to start breathing again.

If you have sinusitis or a blocked nose, your body switches to breathing through the mouth at night. This change may seem minor, but it increases your risk of airway collapse for a few reasons:

• Mouth breathing causes the jaw to open, which moves it backward and narrows the airway.
• The muscles that normally keep the airway open get shorter and weaker with mouth breathing.
• The back of the tongue can fall into the throat more easily, blocking airflow.

All of this makes your airway more vulnerable to collapsing while you sleep—especially if you also have other risk factors like obesity or sleeping on your back.

Scientific Support

A study by Fitzpatrick et al. found that people who breathe through their nose while sleeping experience less resistance in their airway than those who breathe through their mouth. Nasal breathing keeps the airway more stable, while mouth breathing leads to more frequent blockages.

Even small changes in the size or shape of the airway—like those caused by sinus inflammation, swollen nasal tissues, or a deviated septum—can trigger or worsen sleep apnea.

What the VA Says

The Board of Veterans’ Appeals (BVA) has recognized this connection in past decisions. In a case decided on December 24, 2003 (Citation Nr: 0336453), the Board reviewed whether a veteran’s service-connected sinusitis contributed to his sleep apnea.

Initially, one VA examiner didn’t see an obvious link. However, a more recent opinion from the veteran’s primary care doctor concluded that the sinus condition significantly contributed to the sleep apnea, even if it wasn’t the only cause.

The Board ultimately ruled in the veteran’s favor, applying the principle of reasonable doubt under 38 C.F.R. § 3.102—which says that when the evidence is evenly balanced, the benefit goes to the veteran.

Bottom Line

If you have a service-connected nasal or sinus condition and also suffer from sleep apnea, there’s growing medical and legal recognition that these issues are often linked. If nasal obstruction forces you to breathe through your mouth while sleeping, it may be a major factor in the development or worsening of obstructive sleep apnea.

This connection can support a VA disability claim for sleep apnea secondary to sinusitis, rhinitis, or a deviated septum—especially when backed by a strong medical opinion.