Sleep is essential for physical and mental well-being, but for many veterans, insomnia becomes a long-term struggle after military service. Insomnia is more than just occasional sleeplessness—it is a chronic condition that makes it difficult to fall asleep, stay asleep, or achieve restorative rest. Left untreated, insomnia can lead to severe fatigue, mood disturbances, cognitive impairment, and an increased risk of other health complications. Many veterans have insomnia due to service-related conditions such as post-traumatic stress disorder (PTSD), anxiety, depression, chronic pain, or traumatic brain injury (TBI).

The VA recognizes insomnia as a disabling condition when it can be linked to military service. However, proving that insomnia is service-connected can be challenging. Many claims are denied due to insufficient medical evidence or a lack of a clear link between the veteran’s insomnia and their time in service. This is where a VA nexus letter becomes crucial. A well-documented nexus letter from a medical professional can help establish the necessary connection, increasing the chances of approval for VA disability benefits.

Are VA Disability Benefits Available for Insomnia?

Veterans who prove their insomnia is connected to their military service can qualify for VA disability benefits. The VA recognizes insomnia as a disabling condition when it significantly impacts a veteran’s daily life, work performance, and overall well-being.

There are two primary ways insomnia can be considered service-connected. First, direct service connection applies when insomnia begins during active duty and is documented in military service records. Veterans who experienced chronic sleep disturbances during their service, whether due to combat stress, irregular work schedules, or environmental factors, may be eligible under this category. Second, a secondary service connection applies when insomnia is caused or aggravated by another service-connected condition. Common conditions linked to insomnia include PTSD, depression, anxiety, chronic pain, and TBI. Veterans already receiving VA benefits for these conditions may be able to claim insomnia as a secondary disability.

Once a service connection is established, the VA assigns a disability rating based on severity. This rating determines the level of monthly compensation a veteran may receive.

Understanding VA Ratings for Insomnia

The VA assigns disability ratings for insomnia based on the severity of symptoms and how they impact a veteran’s daily life. Unlike conditions with clear-cut diagnostic criteria, insomnia is evaluated under the schedule of ratings for mental disorders. This means it is often rated under conditions like chronic adjustment disorder, anxiety, or depression rather than as a stand-alone diagnosis.

VA disability ratings for insomnia generally fall into four categories: 0%, 10%, 30%, 50%, 70%, or 100%, depending on the level of impairment. A 0% rating is assigned if insomnia is diagnosed but does not significantly impact daily functioning. A 10% to 30% rating is given when insomnia causes mild to moderate symptoms such as trouble sleeping, daytime fatigue, or mild work interference. Veterans experiencing severe symptoms, including chronic sleep deprivation, significant cognitive impairment, depression, or an inability to maintain employment, may receive a 50% to 70% rating. In extreme cases where insomnia leads to total occupational and social impairment, a 100% rating may be assigned.

Because insomnia often worsens over time, veterans who experience deteriorating conditions may need to request a rating increase. Providing updated medical records, sleep studies, and a VA nexus letter supporting the connection between insomnia and military service can help ensure the appropriate rating is assigned.

Common Causes of Insomnia Among Veterans

Insomnia is a widespread issue among veterans, often stemming from the physical and psychological demands of military service. Many service members experience chronic sleep disturbances that persist long after leaving active duty. Understanding the underlying causes of insomnia is crucial for veterans seeking VA disability benefits, as it helps establish a service connection and strengthens their claim. Below are some of the most common causes of insomnia among those who have served.

Post-Traumatic Stress Disorder and Anxiety

PTSD is one of the most frequently cited causes of insomnia among veterans. Those who have experienced combat, military sexual trauma (MST), or other traumatic events often suffer from hypervigilance, nightmares, and exaggerated startle response, all of which make it difficult to fall and stay asleep. Many veterans with PTSD develop a heightened state of alertness, where the body remains on edge even in safe environments, preventing restful sleep.

Traumatic Brain Injury

Veterans who have suffered a TBI due to blasts, falls, or vehicle accidents often experience chronic sleep disturbances. TBIs can disrupt the brain’s regulation of sleep-wake cycles, leading to difficulty falling asleep, frequent nighttime awakenings, and non-restorative sleep. Additionally, veterans with TBIs may suffer from headaches, dizziness, and cognitive dysfunction, further complicating their ability to get restful sleep.

Chronic Pain and Physical Injuries

Many veterans live with chronic pain resulting from service-related injuries, including musculoskeletal conditions, joint damage, or nerve pain. Persistent discomfort makes it difficult to find a comfortable sleep position and often leads to frequent awakenings throughout the night. Pain-related insomnia can be further exacerbated by conditions such as arthritis, fibromyalgia, and spinal injuries, all of which interfere with sleep quality.

Medication Side Effects

Veterans often take medications for pain management, mental health conditions, or other service-related illnesses, many of which have insomnia as a side effect. Stimulants, antidepressants, and certain blood pressure medications can increase alertness, nighttime restlessness, and disrupted sleep cycles. Even medications prescribed for PTSD or depression may lead to sleep disturbances, making it harder for veterans to maintain a regular sleep schedule.

Military Shift Work and Irregular Sleep Schedules

Many military personnel work irregular shifts, night watches, or rotating schedules during service, which can permanently alter their circadian rhythm and lead to long-term sleep difficulties. Veterans who spent years adapting to erratic sleep cycles often struggle to establish a consistent sleep routine in civilian life. This type of sleep disruption can develop into Shift Work Sleep Disorder, where the body’s internal clock fails to adjust to regular sleep-wake cycles.

Substance Use and Withdrawal

Veterans commonly use alcohol, caffeine, nicotine, and other substances as coping mechanisms for stress, anxiety, and PTSD. While alcohol may initially induce drowsiness, it disrupts sleep architecture, leading to fragmented sleep and early awakenings. Veterans who have used prescription sleep aids, painkillers, or other substances for extended periods may also experience withdrawal-related insomnia when trying to reduce or stop usage.

Mental Health Disorders

Depression, bipolar disorder, and other mood disorders frequently contribute to insomnia. Veterans with depression often experience early morning awakenings and difficulty returning to sleep, while those with bipolar disorder may experience periods of excessive energy followed by sleep disturbances. Sleep and mental health are deeply connected, and untreated psychiatric conditions often lead to chronic sleep deprivation.

How to Get a Service Connection for Insomnia

There are different options for establishing a service connection for insomnia. This can be done in three ways: through direct service connection, where insomnia began during active duty; secondary service connection, where insomnia results from another service connected; or aggravation, where a pre-existing sleep condition worsened due to service. Successfully proving a service connection requires strong medical evidence, including sleep studies, medical records, and a VA nexus letter.

Obtain a Sleep Study

A sleep study is critical to medical evidence in an insomnia claim. This test, conducted in a sleep clinic or with at-home monitoring, evaluates sleep patterns, disturbances, and potential underlying conditions such as sleep apnea. While insomnia is often diagnosed through clinical interviews, a documented sleep study can strengthen a VA claim by providing objective evidence of sleep disruptions. If a veteran has never undergone a sleep study, they should request one from their primary care provider or a VA medical facility. This helps demonstrate the severity of insomnia and its effects on health and daily life.

Identify the Cause of Insomnia

The next step is determining whether insomnia is a primary condition or a secondary condition caused by another service-connected disability. If a veteran is already service-connected for one of these conditions, linking insomnia as a secondary condition can increase the likelihood of claim approval. Veterans should gather medical records, personal statements, and supporting evidence to illustrate how insomnia developed or worsened due to service-related factors.

Secure a Nexus Letter

A VA nexus letter is one of the most important documents in an insomnia claim. This letter, written by a medical professional, explicitly states that it is “at least as likely as not” that the veteran’s insomnia is connected to their military service. Without a firm opinion from the author, these letters will not be useful.

The letter should explain the veteran’s medical history, detail the impact of insomnia on their daily lives, and provide supporting clinical evidence. Since many VA claims are denied due to insufficient proof of service connection, a well-documented nexus letter can decide whether to approve the claim.

What Is a Nexus Letter?

A VA nexus letter is a written medical opinion from a qualified healthcare provider that establishes a direct connection between a veteran’s disability and their military service. In the case of insomnia, a nexus letter is crucial in proving that the condition is either directly related to service or secondary to another service-connected condition.

A strong nexus letter explains the veteran’s medical history, the diagnosis of insomnia, and how it is linked to military service. The doctor must state that it is “at least as likely as not” that the veteran’s insomnia was caused or aggravated by their time in service. This phrase is important because it aligns with the VA’s standard for determining service connections. Letters also rely on research from medical journals to establish how insomnia could be service-connected.

Because many VA claims for insomnia are denied due to a lack of medical evidence, a well-documented nexus letter can substantially improve the chances of approval. It provides the medical justification necessary to support the veteran’s claim, making it harder for the VA to dispute the connection between insomnia and military service.

Appealing a Denied Insomnia Claim

A denied VA disability claim for insomnia can be frustrating, but veterans have the right to appeal the decision. Many claims are initially rejected due to insufficient medical evidence, lack of a clear service connection, or an improper disability rating. Understanding why the claim was denied and taking the necessary steps to strengthen the appeal can significantly improve the chances of approval. It is also at this stage that hiring an attorney becomes an option.

The first step in appealing a denied claim is to carefully review the VA’s decision letter, which outlines the reasons for the denial. If the VA determined no proven link between insomnia and military service, there are ways to counteract these arguments on appeal. A nexus letter from a medical professional with experience with insomnia cases can establish the missing service connection that leads to many denied claims.

Veterans can choose from different appeal options, including a Higher-Level Review, a Supplemental Claim, or an appeal to the Board of Veterans’ Appeals. A Supplemental Claim is often the best option if new evidence, such as a VA nexus letter, updated medical records, or a sleep study, supports the case.

If insomnia symptoms have worsened over time, veterans may also request a higher disability rating by providing new medical documentation. Seeking assistance from a VA-accredited attorney or veterans’ advocate can help ensure the strongest possible appeal. By submitting additional evidence and adequately addressing the VA’s concerns, veterans can improve their chances of receiving disability benefits for insomnia.

Get Help With Finding a Nexus Letter For Your Insomnia Claim

Your service has earned you the right to seek benefits from the VA for any injuries or illnesses related to your time in the military. This includes frustrating sleep conditions like insomnia. If you are ready to make the strongest case possible, contact Elite Medical Review Associates immediately to learn more.