Why the VA Should Use Veteran Data—Not Just General Population Statistics
The Veterans Affairs (VA) Board of Appeals made a critical error by relying on general population data to evaluate the causes of obstructive sleep apnea (OSA). In the civilian world, sleep apnea is most often linked to obesity and aging. But for veterans, the reality is very different.
In the veteran population, PTSD, mood disorders, and tinnitus are far more common—and they play a significant role in causing or worsening sleep apnea. These conditions are service-connected and much more prevalent among veterans than in the general public. Yet the VA’s expert relied only on general public data [R. at 1480], ignoring studies and statistics specific to veterans.
What the VA’s Own Research Shows
The VA’s own publications clearly state that sleep apnea is more common in veterans with PTSD than in the general population. Here’s what a VA-sponsored article says:
“Insomnia is one of the most common symptoms of PTSD and has been reported to occur in 90–100% of Vietnam-era veterans with the disorder. In the Millennium Cohort Study, 92% of active-duty personnel with PTSD—compared to just 28% of those without PTSD—reported clinically significant insomnia.
It is important to be aware that insomnia and recurrent nightmares are often not the only sleep disorders that individuals with PTSD experience. There is growing evidence that this population also suffers from obstructive sleep apnea (OSA) more often than the general population.”
(PTSD Research Quarterly, National Center for PTSD)
This means the VA is aware that PTSD doesn’t just cause insomnia—it also increases the likelihood of developing obstructive sleep apnea, a serious and potentially life-threatening condition.
Veteran-Specific Research Confirms Higher OSA Rates
In a large study conducted across all 140 Veterans Health Administration (VHA) facilities, researchers led by Babson et al. reviewed records of 2.48 million obese veterans. Their findings were striking:
- Veterans had nearly twice the rate of OSA compared to civilians.
- The risk was especially high in veterans with PTSD or mood disorders.
- This higher incidence of OSA was not explained by obesity alone.
These findings make it clear: obesity is not the only cause of sleep apnea in veterans. Conditions like PTSD and depression, which are far more common among those who served, are major contributing factors.
The Bottom Line
The VA should not base decisions about veteran health solely on general population data. Veterans face unique risks and challenges that demand veteran-specific research and consideration.
Sleep apnea in veterans is often the result of service-related mental health conditions, not just weight or age. Ignoring these facts leads to unfair denials of benefits and undermines the very purpose of the VA: to serve those who served us.