Denied sleep study
Long story short, im service connected for PTSD with Insomnia and AUD. Im in the process of filing a secondary claim for OSA and I requested a sleep study but I was denied by the VHA sleep clinic due to alcohol consumption being too high. I went and got a private sleep study that confirmed OSA and got a prescription for cpap but when I requested the va upload my sleep study report to my records and prescribe the cpap, they once again denied. Has anyone experienced this or anything similar? Does this response I recieved twice now from the sleep clinic help my secondary claim for OSA due to PTSD with Insomnia and AUD and associated weight gain at all?
"Sleep Quality and Alcohol's Impact
• The veteran may require a sleep study in the future.
• At this time, however, veteran is drinking in excess of healthy adult limits and is not getting sufficient sleep, both of which can mimic OSA.
• Patient's goal should be MINIMUM 6 hours of sleep nightly, ideal 7-8 hours of sleep nightly.
• In those that have disrupted sleep and complaints POSSIBLY c/w OSA, even one drink is associated with worsening apnea number and length.
• Abstinence is ideal but reduction to one drink, less times per week, and no more than 2 hours prior to bedtime would help.
• Once the veteran HAS STOPPED DRINKING FOR SIX months (this length is chosen to resolve the typical prolonged insomnia associated with alcohol withdrawal) and can sleep at least 5-6 hours on a regular schedule, please reconsult.
Understanding Alcohol's Physiological Effects
• Alcohol suppresses breathing, causes CNS depression and relaxes upper airway muscles and well known to cause snoring, gasping and apnea.
• Many veterans are not aware of the close association between disrupted sleep.
Alcohol's Impact on Sleep Apnea
• sleep and alcohol use.
• Alcohol use closely mimics as well as exacerbates OSA.
• In the interim please treat with NON PAP interventions.
Addressing Daytime Sleepiness and Poor Sleep
• For ALL patients who complain of poor sleep/excessive daytime sleepiness:
• advise to avoid driving while sleepy
• advise to avoid EtOH anc opiates/benzodiazepines and all sedative hypnotics
Strategies for Snoring Management
• For snoring:
• A positional therapy (avoid sleeping supine)
• weight loss of even 10-15 pounds can be helpful
• controlling any nasal congestion aggressively with antihistamines, decongestants
• treating GERD may be effective
• sleeping 6.5-7.5 hours on a regular schedule"