VA lists four levels for obstructive, central, and mixed sleep apnea syndromes based on respiratory failure, prescribed breathing assistance, and documented symptoms.
Plain-language summaries explain the text; they do not decide whether any level applies.
Chronic respiratory failure with carbon dioxide retention or cor pulmonale, or; requires tracheostomyPlain-language summary
The highest level addresses the listed chronic respiratory failure, cor pulmonale, or tracheostomy paths.
Requires use of breathing assistance device such as continuous airway pressure (CPAP) machinePlain-language summary
This level addresses required use of a breathing-assistance device such as CPAP.
Persistent day-time hypersomnolencePlain-language summary
This level addresses persistent daytime excessive sleepiness.
Asymptomatic but with documented sleep disorder breathingPlain-language summary
The schedule lists a noncompensable level for documented sleep-disordered breathing without symptoms.
38 CFR § 4.97, DC 6847 · Effective Oct 7, 1996 · Reviewed Jul 24, 2026