Obstructive Sleep Apnea and Your Time in Service

4-26-2025

By Dr. Howard Friedman, MD | Veteran | U.S. Army Medical Corps | Internal Medicine | HHOM LLC

Military service can increase the risk of obstructive sleep apnea. Learn how service-related factors may contribute to this serious condition—and what it means for your VA claim.

The night should heal, restore, renew—

But broken sleep cuts deep and true.

Each breath denied, each dream erased,

Leaves aching limbs and time misplaced.

Yet in that dark, a cause takes shape—

And naming it becomes escape.

---Dr. Howard Friedman MD

Obstructive Sleep Apnea (OSA) is a serious and often overlooked condition where breathing repeatedly stops and starts during sleep due to an obstruction in the upper airway. It is a dual burden on the body: it robs you of restful sleep—an essential pillar of health—and creates a disorder of oxygenation. Over time, the body is placed under a relentless strain. This strain, known as oxidative stress, acts much like a slow burn, fueling the inflammation that underpins many of the chronic diseases we face today.

You cannot talk about health without talking about inflammation. Inflammation is not a villain in and of itself—it is part of our body's defense system. But when it becomes chronic, it turns against us, quietly setting the stage for conditions like heart disease, diabetes, and cognitive decline. One of the wisest paths to lifelong health is minimizing unnecessary inflammation. And the real keys to fighting inflammation? They have not changed in generations: proper diet, regular exercise, and deep, restorative sleep. Ignore any one of these, and your foundation weakens.

Ultra-processed foods flood the modern diet with inflammatory agents. Exercise, far from being a punishment, actually calms the body and resets stress responses. And then there is sleep—the most overlooked and most essential act of healing. Sleep is not a luxury; it is a biological mandate, a ritual that every living creature obeys.

When we talk about Obstructive Sleep Apnea in veterans, the conversation becomes even more urgent. Research consistently shows that veterans are about twice as likely to develop OSA compared to their civilian counterparts. That’s not a small difference—and it's not fully explained by anatomy alone. Something about military service leaves an imprint.

The truth is, no single answer explains it. Stress, trauma, disrupted sleep during service, physical injuries, changes in weight, exposure to toxins, and comorbid conditions all probably play a role. There is also a condition called COMISA (co-morbid insomnia and sleep apnea) that is particularly common among veterans. It’s not just about obstructed breathing; it’s about a whole network of disrupted sleep architecture, insomnia, and breathing abnormalities—working together to steal your rest, night after night.

It is possible that some of the civilian numbers underestimate the prevalence of OSA simply because civilians are less likely to have someone notice and report the signs. Veterans, statistically, are more likely to have been married at some point than their civilian peers (though they are also more likely to experience divorce). Having a partner sleeping beside you makes it far more likely someone will notice the choking sounds, loud gasps, or interrupted breathing that hallmark OSA. Left alone, many veterans simply wake up exhausted and blame it on stress, aging, or a "bad night"—missing the underlying cause altogether.

The cruel reality of OSA is that you do not hear yourself during these episodes. You do not fully awaken, but your brain keeps getting yanked back into lighter sleep stages to restart breathing. You are caught in a cycle of survival rather than restoration. Morning after morning, it feels like you never slept at all.

If you are a veteran—and first, let me say thank you for your service—you need to listen carefully to your body. If you sleep alone and wake up every day feeling exhausted, if you find yourself falling asleep during the day, struggling to concentrate, waking up with headaches, or battling persistent fatigue, do not dismiss it. See your doctor. You owe it to yourself. It may be Obstructive Sleep Apnea. It may also be another condition, like central sleep apnea, restless leg syndrome, or other sleep disorders that only a proper sleep study can uncover.

At Howard’s House of Medicine (HHOM LLC), you are never alone on this journey. I built this practice so veterans like you could have a place to turn for real answers. If you have questions about sleep apnea, service connection, health strategies, or simply need guidance, you can always reach me directly through our Ask Dr. Howard button. I will do my best to answer your questions with the care and respect you deserve.

No shortcuts. No empty promises. Just real support.

—Dr. Howard Friedman, MD

Board-Certified | Internal Medicine | Veteran | U.S. Army Medical Corps

Founder of Howard’s House of Medicine (HHOM LLC)

https://www.hhomllc.com

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Frequently Asked Questions:

Question: Can military service cause or worsen obstructive sleep apnea?

Answer: Yes. Factors like burn pit exposure, disrupted sleep schedules, high stress, and respiratory irritants during service can all contribute to the onset or aggravation of obstructive sleep apnea. These conditions are common among veterans.

Question: Why does the VA deny so many sleep apnea claims?

Answer: The VA requires a clear medical nexus between your sleep apnea and your military service. Without documentation, in-service symptom reports, or a qualified medical opinion, claims are often denied—even if the connection is valid.

Question: How can HHOM LLC help with a sleep apnea VA claim?

Answer: Dr. Howard Friedman provides expert Nexus Letters that connect your sleep apnea to your military service or a secondary condition like PTSD or obesity. His opinions are evidence-based, personalized, and built to stand up to VA scrutiny.