Confirm A Medical Diagnosis Of Sleep Apnea With A Sleep Specialist
Once youve finished your Sleep Study, its important to review your results with a sleep specialist.
Its crucial to review your Sleep Study results in detail, specifically, to confirm whether you have a medical diagnosis of Sleep Apnea.
By far, the most common Sleep Apnea syndrome in Veterans is called Obstructive Sleep Apnea .
Did you know Veterans are nearly 4x as likely to have Obstructive Sleep Apnea as the average civilian population?
A quick note: According to medical research, the most common cause of Obstructive Sleep Apnea is WEIGHT GAIN / OBESITY.
This is really important!
Because weight gain / obesit is the #1 most common reason why the VA denies Sleep Apnea claims.
The C& P examiners will write some ridiculous denial such as, Its less likely than not that the Veterans Sleep Apnea is due to their military service. The most likely cause is weight gain / obesity, which occurred after they left the military. The Veteran has a BMI above 30.
As Ive explained before, the trouble with the C& P exam system is that medical providers are used to applying medical certainty principles to evaluate probability.
However, the VA rating system is supposed to be non-adversarial and NOT based on medical certainty.
The concept of medical certainty is a much higher standard of proof than is required for a claimant under the VA disability system.
Submitting The Correct Wording For Asbestos
In order to have an asbestos-related, military service-connected disability claim approved by the Department of Veterans Affairs , a veteran must show they have a diagnosis the VA recognizes can be caused by exposure to asbestos.
The VA recognizes the several diseases as asbestos-related, according to the M21-1 Compensation and Pension Manual Rewrite. Each has specific requirements for filing a VA claim.
Eligible conditions include:
Mesotheliomas of pleura and peritoneum
Cancers of the lung, bronchus, gastrointestinal tract, larynx, pharynx and urogenital system except the prostate
People with significant asbestosis often develop cor pulmonale and heart disease secondary to disease of the lung or its blood vessels.
All diagnoses with the exception of pleural mesothelioma, peritoneal mesothelioma and asbestosis also require a nexus statement from a medical specialist linking the disease to exposure to asbestos.
How To Prove Service Connection For Sleep Apnea: The 6
- Step #1: Get a NEW Sleep Study
- Step #2: Confirm a medical diagnosis of Sleep Apnea with a sleep specialist
- Step #3: Conduct a Sleep Apnea Gap Analysis to include medical research and case law precedent
- Step #4: Determine Direct Service Connection vs. Secondary Service Connection
- Step #5: Obtain a Nexus Letter for Sleep Apnea
- Step #6: Get at least one VA Buddy Letter for Sleep Apnea
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Conduct A Sleep Apnea Gap Analysis To Include Medical Research And Case Law Precedent
In this step, youll want to conduct a gap analysis of your VA Sleep Apnea disability, to include the approximate timeframe that your symptoms began.
If you have your Service Treatment Records, go through them in detail, and look for any complaints or symptoms related to Sleep Apnea.
If you did have a Sleep Study on active duty, and you have a diagnosis in your Service Treatment Records, make sure to annotate this in your Lay Statement for Sleep Apnea.
In our experience, however, most Veterans didnt do a Sleep Study during the military, which is critical to note prior to moving onto Step #4.
The final part of Step #3 is to conduct some Google Searches of medical research and BVA case law decisions for your VA Sleep Apnea claim.
If youd like to save some time and effort in your research, you can download my FREE eBook, which includes medical research studies and BVA cases for Sleep Apnea:
Youll learn 3 critical things about service connection for Sleep Apnea:
- HOW to get your Sleep Apnea VA claim service connected
- DISCOVER 50+ conditions linked to Sleep Apnea and WHY the word aggravated may be key for you!
- BONUS! FREE video explains how to WIN, and SERVICE CONNECT Sleep Apnea in LESS TIME!
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Symptoms Of Asthma May Contribute To Sleep Apnea
Response from Lyn Harper, MPA, BSRT, RRT:
Different studies have definitely shown a link between asthma, sleep apnea, and snoring. First of all, if you suffer from asthma, you know that if its not well controlled, and even sometimes when it is, you wake up at night with difficulty breathing. You may be wheezing and your chest feels very tight.
In addition, these same studies suggest that people with asthma are at increased risk to develop sleep apnea. Sleep apnea can cause increased inflammation in the airways a problem that can trigger irritation and constriction of the small airways, leading to worsening asthma. Many people with sleep apnea complain of nasal congestion which can also contribute to snoring and an exacerbation of asthma.
Since sleep is essential for a good quality of life, its very important to find the underlying cause for wakefulness at night. If its asthma, find out the triggers. Rid your bedroom of upholstery, pet dander, dust mites, and any other allergens that may cause worsening asthma at night.
Be vigilant about taking medications as prescribed. If you suspect you have sleep apnea, speak to your doctor about it. He or she may recommend you have a sleep study. Sleep apnea can become worse if we carry extra weight around, so try to maintain a healthy weight by a good diet and regular exercise.
What Every Physician Needs To Know:
Asbestos-related pulmonary disorders consist of a group of malignant and benign inflammatory-fibrotic disorders associated with exposure to asbestos fibers. The term asbestos refers to a group of six hydrated magnesium silicate minerals. Since asbestos is almost indestructible and it is resistant to heat, fire and chemicals and does not conduct electricity, various types of this material have been used in construction, automotive and other industries for many years.
Asbestos has the tendency to separate into fibers, which cause parenchymal and pleural pulmonary disorders when inhaled. Malignant and benign disorders associated with exposure to asbestos fibers usually occur decades after exposure. Benign asbestos-related diseases include asbestosis, restrictive lung disease, rounded atelectasis, pleural plaques, diffuse pleural thickening, and exudative pleural effusions.
The general criteria for diagnosis of asbestos-related lung disorders are:
a clinical syndrome consistent with an asbestos-related pulmonary disorder
a history of exposure to asbestos as documented by occupational and environmental history, or presence of markers of exposure
evidence of pathology consistent with asbestos-related disease, as documented by imaging or histology
exclusion of alternative plausible causes for the findings.
identification and assessment of the pattern and degree of impairment, if present.
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Why Wildfire Smoke Is Dangerous
Wildfires can pose a significant threat to our lungs. Smoke contains several respiratory irritants, such as particulate matter and hydrocarbons, but the greatest risk is from ultrafine particles that are inhaled during a fire. These particles can create nasal congestion and cause your eyes to sting and burn. The added risk of wildfires, as opposed to other types of smoke, is that they release thousands of airborne chemicals many of which are toxic. Even if youre not close to the fire itself, these chemicals can travel several hundred miles.
- People with preexisting heart or lung diseases, particularly elderly people
- Children, whose airways are developing, and who breathe more air per pound of body weight than adults
- Pregnant women
What You Can Do To Improve Sleep
There are several steps you can take in order to sleep better. The first step is to make sure that your asthma is under good control. You may have to visit with your health care provider to be evaluated. This will help to insure that you are getting the right medical treatment. You can then develop a series of steps to take, to control your asthma and guide you through an episode of sudden breathlessness.
Your provider will instruct you when to use your rescue inhaler or pursed lip breathing, and what questions to ask yourself about your condition, should you experience any sudden breathlessness. Also, talk to your health care provider if you have nasal congestion or get heartburn, to get them under better control. If you smoke, quitting smoking will not only help your asthma, but the quality of your sleep will also improve. Tell your health care provider if you think you may have sleep apnea so that you can be evaluated. Sleep apnea is a treatable condition!
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Which Individuals Are At Greatest Risk Of Developing Asbestos
1) Older patients in high-risk occupations with high levels of asbestos exposure, such as textile, construction or shipyard workers, plumbers, mechanics, miners, and factory workers . Their families may have had passive exposure when workers carried asbestos home on their clothing. Family exposure primarily is relevant in mesothelioma.
Chest Radiograph showing basilar interstitial opacities consistent with asbestosis. Credit: WN Rom, MD, NYU School of Medicine
2) Workers in occupations that involved the management of the remaining asbestos hazard, such as building and facility maintenance, asbestos-abatement operations, and the renovation and demolition of structures containing asbestos.
3) In the developing world, workers and their families continue to be exposed to asbestos. In some former Eastern bloc nations and rapidly industrializing countries in Asia, the use of asbestos may even be increasing.
4) Environmental exposure to asbestos can occur in certain geographic areas. Exposure to large amounts of dust containing asbestos can occur during catastrophic events like the 2001 World Trade Center collapse in New York because some of the buildings had asbestos.
What Causes Obstructive Sleep Apnea
Blocked or narrowed airways in your nose, mouth, or throat can cause sleep apnea. Your airways can become blocked when your throat muscles and tongue relax during sleep.
Sleep apnea can also occur if you have large tonsils or adenoids. During the day, when you are awake and standing up, these may not cause problems. But when you lie down at night, they can press down on your airway, narrowing it and causing sleep apnea. Sleep apnea can also occur if you have a problem with your jawbone.
In children, a common cause of sleep apnea is large tonsils or adenoids.
Sleep apnea is more likely to occur if you are overweight, use certain medicines or alcohol before bed, or sleep on your back.
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Continuous Positive Airway Pressure
is nearly always the first medical treatment for sleep apnea. With CPAP, you use a breathing machine that prevents your airways from closing during sleep.
Research shows that:
- CPAP decreases daytime sleepiness.footnote 4, footnote 5, footnote 6 If you still feel sleepy during the day while using CPAP at night, tell your doctor.
- CPAP can lower daytime and nighttime blood pressure.footnote 7
It may take time for you to be comfortable using CPAP. You may find that you want to take off the mask, or you may find it hard to sleep. If you can’t get used to CPAP, talk to your doctor. You might be able to try another type of mask or make other adjustments.
Some CPAP devices automatically adjust air pressure or use different air pressures when you breathe in or out. They are easier and more comfortable for some people to use.
If you use CPAP to treat sleep apnea, you need to use it every night and while you nap. If you don’t use it, your symptoms will return right away.
Fda Recall Of Cpap Devices Manufactured By Philips
In its recall notice, the FDA identified three different types of Philips respiratory care devices that posed risks to users, including:
- Bi-level Positive Airway Pressure Devices
- Continuous Positive Airway Pressure Machines
- Mechanical Ventilators
Of the recalled Philips devices, roughly 80% are CPAP machines, particularly those in the first generation of DreamStation machines .
The major safety issue with Philipss CPAP and BiPAP machines involves the sound-reducing foam contained within these devices. In its June alert, the FDA warned that this foam can break down over time and subsequently be inhaled by users of the devices, potentially exposing them to harmful chemicals.
According to complaints received by the FDA, the recalled Philips sleep apnea devices have been associated with serious, potentially life-threatening health complications, including:
- Damage to or failure of the kidneys, liver, or lungs
In a November follow-up to its June alert, the FDA announced that it had conducted a safety inspection of the Philips manufacturing plant where the defective devices were made to learn more about the causes of the defective foam, as well as to ensure Philips is following FDA manufacturing regulations.
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Prevalence Of Obstructive Sleep Apnea In Patients With Asbestos
Symptoms of asbestos-related pulmonary diseases appear gradually only after large areas of the lungs become scarred. The scarring causes the lungs to stiffen. The first symptoms are mild shortness of breath and a decreased ability to exercise. Gradually, breathing becomes more and more difficult. In about 35% of people with asbestosis, for example, severe shortness of breath and respiratory failure develop.
Difficulty breathing during the day and sudden awakenings with a sensation of gasping or choking arise because of pleural thickening caused by the longtime presence of asbestos fibers, or pleural effusion, the buildup of extra fluid in the space between the lungs and the chest wall. Cancerous tumors of the lungs can restrict the regular movement of the lung during breathing, diaphragm, heart, and other organs in the chest and abdominal cavities. Because any abnormal growth in the chest cavity can reduce the space into which the lungs usually expand, breathing becomes more difficult, leading to breathlessness.
Additional Concerns Arise With Replacement Foam
In its November update, the FDA noted that the silicone-based foam Philips is now using as a replacement to their devices original foam has raised additional red flags. The agency identified a similar silicone-based foam marketed outside the U.S. that had previously failed a safety test after it, too, broke down over time, releasing volatile organic compounds that presented safety concerns to users.
As a result, the FDA has requested that Philips contact an independent laboratory to conduct additional testing to determine what potential safety risks may be posed to users by the replacement silicone-based foam.
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Get Help Filing A Philips Cpap Lawsuit
If you have used or currently use a Philips mechanical ventilator, BiPAP, or CPAP machine and have suffered serious injuries as a result, you may be eligible to file a Philips CPAP machine lawsuit for compensation from the product manufacturer.
An established national law firm, Sokolove Law has the resources and reach to fight on behalf of our injured clients and hold powerful companies accountable for their negligence. Over the last 40 years, Sokolove Law has recovered more than $1.5 Billion on behalf of clients affected by dangerous medical devices and drugs.
Get a free case review to learn more about your potential legal options with Sokolove Law.
Diagnosis Of Obstructive Sleep Apnea In Children
Polysomnography with oximetry and end-tidal carbon dioxide monitoring
Obstructive sleep apnea is considered in children with snoring or risk factors. If symptoms of OSA are present, diagnostic testing is done in a sleep laboratory using overnight polysomnography Testing Almost half of all people in the US report sleep-related problems. Disordered sleep can cause emotional disturbance, memory difficulty, poor motor skills, decreased work efficiency, and increased… read more that includes oximetry and end-tidal carbon dioxide monitoring. Polysomnographic criteria for diagnosis is lower than for adults. Home polysomnography is under evaluation.
Polysomnography can help confirm the diagnosis of obstructive sleep apnea, but diagnosis also requires that the child not have a cardiac or pulmonary disorder that could explain the polysomnographic abnormalities. Analysis of sleep stage and the effects of position during polysomnography can help indicate the contribution of upper airway obstruction. Thus, results of polysomnography can help determine initial treatment .
Patients with OSA are evaluated with other tests based on clinical judgment. Other testing may include ECG, chest x-ray, arterial blood gas measurement, and imaging of the upper airway.
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How And/or Why Did The Patient Develop Asbestos
The exact mechanism for pathogenesis is unknown. However, several studies suggest that inhaled asbestos fibers can become lodged in the small bronchioles. In larger airways, asbestos fibers are cleared by mucocilliary clearance. Over time as the fiber burden accumulates, the pulmonary immune system may become overwhelmed and these fibers are no longer effectively cleared. Chrysotile fibers as compared with amphibole fibers are pliable and more readily cleared through macrophage phagocytosis or pneumocyte endocytosis. Large fibers that cannot be completely engulfed become lodged in the lung tissue and are known as asbestos bodies. In addition, pleural damage can occur from cytokine or toxic metabolite release. Fibers can also migrate through lymphatic drainage into the subpleura causing local cytokine release. Asbestos fibers induce a peribronchiolitis and alveolitis that progresses to fibrosis in the interstitium. If the fibers are carried to the periphery of the lung they can induce a pleuritis that results in pleural thickening.