Sleep apnea is a serious sleep disorder characterized by periods in which a sleeping person stops and starts breathing. People with sleep apnea typically stop breathing for 10 to 30 seconds at a time while they're sleeping, and these short stops in breathing can happen up to 400 times every night. When sleep apnea isn't treated, it can cause hypersomnia (excessive daytime sleepiness) or more serious complications like heart or lung problems.
Patients with sleep apnea sleep very poorly and wake up in the morning still feeling tired. Sufferers remain sleepy throughout the day, sometimes falling asleep in the middle of a conversation or while driving. Chronic sleep disruptions caused by apnea can affect daytime alertness, intellectual ability, memory, and mood. Other consequences of undiagnosed sleep apnea include heart attacks, high blood pressure, stroke, and heart disease.
There are two kinds of sleep apnea: obstructive apnea and central apnea. Nine out of ten patients are diagnosed with obstructive apnea.
Obstructive sleep apnea occurs when something blocks the trachea (windpipe), which is the passage that brings air into the body. Possible blockages include relaxed throat muscles, tonsils, uvula, or a large amount of fatty tissue in the throat.
People who are overweight have an elevated risk of developing sleep apnea. Many people affected by obesity have difficulty breathing when they sleep, as fatty tissues in the pharynx and neck can compress and block the airway. Obstructive apnea can cause carbon dioxide levels in the body to rise to uncomfortable and unsafe levels, and may awaken an individual several times throughout the night.
Central sleep apnea, by comparison, is rare. Central sleep apnea is related to the central nervous system and occurs when the brain fails to send the proper signals to the muscles used for breathing, or when the signal sent from the brain is somehow interrupted.
Sleep apnea may be relieved by wearing a positive airway pressure device (CPAP, APAP, or BiPAP) at night. These devices use masks that are worn over the face and connected to pressurized air to assist with breathing.
While most people who have sleep apnea will have a hard time qualifying for disability, those who have suffered serious complications from sleep apnea are more likely to qualify. For instance, if you have pulmonary vascular hypertension, cor pulmonale, heart failure, or a severe cognitive impairment caused by lack of sleep, the Social Security Administration (SSA) may find you eligible for benefits.
Social Security doesn't have an official listing for a sleep apnea disability, but the agency did update its listings recently to give guidance to those with sleep apnea. Social Security's listing for respiratory impairments directs those who suffer from chronic heart failure caused by sleep apnea to use listing 4.02, for heart failure. Likewise, it directs those who suffer from chronic pulmonary hypertension or cor pulmonale due to sleep apnea to listing 3.09. And finally, the listing directs those with cognitive or mood issues caused by sleep apnea to listing 12.02, which covers neurocognitive disorders.
If your condition doesn't meet one of the listing mentioned above, Social Security will continue to look for evidence that you can't work. To determine whether you're able to work, the SSA will prepare an assessment of your "residual functional capacity," or "RFC." Your RFC is what you are capable of doing despite your impairment. Social Security uses your RFC assessment to determine what kind of work you can still do.
To prepare your RFC, the SSA will look at how your fatigue affects your ability to do basic work-activities and whether you have any other impairments, such as a documented heart condition, that limit your ability to exert yourself physically.
Having your doctor write an opinion of your capabilities and restrictions is key to having Social Security do a proper RFC assessment. For example, if you suffer from extreme fatigue that causes you to fall asleep during the day, your doctor may restrict you from driving or operating dangerous equipment. Or, if you have heart failure caused by pulmonary hypertension, your doctor may limit you to lifting only ten pounds, occasionally. Your doctor should also comment on how the sleep apnea affects your mental abilities, if you have documented trouble with your memory, concentration, pace, or social functioning.
The SSA will consider your RFC restrictions and the requirements of your prior job to see if you are able to do it. If not, the SSA will look for other jobs that you are able to do given your functional limitations. Unless you are over 50 and have little education, the SSA is likely to say that there are desk jobs you can do with your limitations. But if the SSA determines that your restrictions are so limiting that you couldn't maintain any type of job (for instance, your fatigue causes you to fall asleep on the job, make mistakes, or misunderstand simple instructions), the SSA may agree that you can't do any jobs.there is no work you can do, you could be awarded benefits. (Learn more about how Social Security decides whether you can work.)
Updated April 22, 2022