Screen for obstructive sleep apnea risk using the STOP-BANG questionnaire. 8 yes/no questions with risk stratification and predictive performance data.
The STOP-BANG questionnaire is a common screening tool for obstructive sleep apnea (OSA), used in preoperative assessments, primary care, and sleep medicine referral triage. Its eight simple yes/no questions — Snoring, Tiredness, Observed apnea, high blood Pressure, BMI > 35, Age > 50, Neck circumference > 40 cm, and male Gender — can be answered in under two minutes without any laboratory testing or equipment.
OSA affects a substantial share of adults, and many moderate-to-severe cases remain undiagnosed. Untreated OSA is associated with hypertension, atrial fibrillation, stroke, type 2 diabetes, motor vehicle accidents, and perioperative complications. STOP-BANG is designed to favor sensitivity over specificity so it can flag people who may benefit from further review.
In the perioperative setting, higher scores often prompt closer chart review because undiagnosed OSA can affect anesthesia and recovery planning. This calculator keeps the questionnaire, risk band, and screening context together, but it should still be treated as a screening aid rather than as a stand-alone management rule.
With many moderate-to-severe OSA cases still undiagnosed, STOP-BANG offers a rapid way to summarize sleep-apnea screening risk in clinic, preoperative assessment, or referral triage. Its main value is that it makes the questionnaire easy to score consistently and keeps the predictive context beside the raw total.
STOP-BANG Score = Sum of Yes answers (0-8) S: Snoring (loud) → 1 point T: Tired/Sleepy during day → 1 point O: Observed stop breathing → 1 point P: Blood Pressure (treated) → 1 point B: BMI > 35 → 1 point A: Age > 50 → 1 point N: Neck > 40 cm → 1 point G: Gender (Male) → 1 point
Result: STOP-BANG = 5 — High risk for moderate-to-severe OSA
Five out of eight criteria are met (snoring, tiredness, BMI > 35, age > 50, male gender). That places the questionnaire in the high-risk band, which is often used to justify formal sleep evaluation or closer preoperative chart review.
STOP-BANG is designed to be sensitive, not definitive. That is why many people with scores of 3 or more will still need clinical follow-up before anyone can say whether true obstructive sleep apnea is present.
The questionnaire is used in primary care, sleep referral triage, and preoperative assessment because it captures both symptoms and structural risk factors in one short screen. The score itself stays the same, but the next step depends on context.
A low score lowers suspicion but does not rule OSA out in every patient. A high score raises suspicion, especially for moderate-to-severe disease, but it is still only a screening result until formal testing and clinical review are done.
Last updated:
This worksheet applies the published STOP-BANG yes/no criteria to the entered screening answers, then groups the total into familiar screening bands. It is a screening aid for discussion and chart review, not a diagnosis of obstructive sleep apnea.
A STOP-BANG ≥ 3 is usually treated as an elevated screening result rather than a diagnosis. The tool is designed to catch more people who may have OSA, which means it can also flag many who ultimately do not have it. The formal diagnosis still requires polysomnography.
Absolutely. Women can score up to 7 on the other criteria. OSA is underdiagnosed in women because they often present differently — with insomnia, morning headaches, and fatigue rather than classic loud snoring. The male gender criterion reflects the 2:1 male predominance, not exclusivity.
An overnight sleep study (PSG) monitors brain waves (EEG), eye movements, muscle tone, airflow, respiratory effort, oxygen saturation, heart rhythm, and body position during sleep. It determines the Apnea-Hypopnea Index (AHI) — the number of breathing disturbances per hour — which defines OSA severity.
Epworth measures daytime sleepiness specifically and has lower sensitivity for OSA than STOP-BANG. STOP-BANG is preferred for OSA screening because it includes demographic and anthropometric risk factors. Epworth is useful for monitoring treatment response and assessing hypersomnolence from any cause.
Large neck circumference (> 40 cm / 16 inches) indicates increased soft tissue around the airway, which predisposes to airway collapse during sleep. It is an independent risk factor for OSA even after controlling for BMI, making it a uniquely informative screening criterion.
Possible OSA can matter during surgery and recovery because airway management, sedation, opioid sensitivity, and postoperative breathing observations may need closer review. A positive STOP-BANG result is screening context rather than a stand-alone perioperative plan.