A score of 3 seems very common — does everyone have OSA?

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.

Can women have OSA despite the G (male gender) criterion?

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.

What happens during a polysomnography (sleep study)?

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.

How does STOP-BANG compare to Epworth Sleepiness Scale?

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.

Why is neck circumference included?

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.

What are the perioperative concerns around possible OSA?

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.

STOP-BANG Score — OSA Screening Calculator

Screen for obstructive sleep apnea risk using the STOP-BANG questionnaire. 8 yes/no questions with risk stratification and predictive performance data.

⚠️ Clinical Note: STOP-BANG is a screening tool, not a diagnostic test. Use it to summarize sleep-apnea risk and referral context; definitive diagnosis still depends on formal testing and clinical review.

STOP-BANG Questions

S — Do you SNORE loudly?

T — Do you often feel TIRED or sleepy during the day?

O — Has anyone OBSERVED you stop breathing in sleep?

P — Are you treated for high blood PRESSURE?

B — BMI > 35 kg/m²?

A — AGE > 50 years?

N — NECK circumference > 40 cm (16 in)?

G — GENDER — Male?

STOP-BANG Score

5 / 8

High Risk

OSA Risk

High Risk

High probability of moderate-to-severe OSA — formal testing is often discussed from here

Perioperative Context

Flag for review

Many surgical pathways review OSA risk more closely from here

Screening Follow-up

Discuss formal testing

High probability of mod-severe OSA on screening

STOP-BANG: 5 / 8 — High Risk for OSA

High probability of moderate-to-severe OSA — formal testing is often discussed from here

Item Breakdown

Letter	Question	Answer	Points
S	Snoring — Loud snoring?	Yes	1
T	Tired — Daytime fatigue/sleepiness?	Yes	1
O	Observed — Observed stop breathing?	No	0
P	Pressure — Treated for high blood pressure?	No	0
B	BMI > 35 kg/m²?	Yes	1
A	Age > 50?	Yes	1
N	Neck circumference > 40 cm (16 in)?	No	0
G	Gender — Male?	Yes	1
Total Score			5

Risk Stratification

Score	Risk Level	Probability of OSA	Action
0–2	Low	Low	Questionnaire stays in the low-risk band
3–4	Intermediate	Moderate	Often prompts a more detailed sleep-history review
5–8	High	High (mod–severe OSA)	Often used to justify formal testing or closer perioperative review

Predictive Performance

Cutoff	Sensitivity	Specificity	Best For
≥ 3	93%	36%	Screening (high sensitivity)
≥ 5	56%	80%	Moderate-severe OSA
≥ 6	43%	90%	Severe OSA

Planning notes, formulas, and examples

About the STOP-BANG Score — OSA Screening Calculator

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.

When This Page Helps

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.

How to Use the Inputs

Answer each of the 8 STOP-BANG questions as Yes or No.
For "Observed apnea," select Unsure if no bed partner has reported this.
Each Yes answer scores 1 point; the total ranges from 0 to 8.
Review the risk classification (Low: 0-2, Intermediate: 3-4, High: 5-8).
Use the score to summarize screening risk and decide whether formal sleep evaluation is worth discussing.
If surgery is planned, treat the result as chart-review context rather than as a complete perioperative pathway by itself.

Formula used

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

Example Calculation

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.

Tips & Best Practices

Use the same wording each time you ask the questions so repeat scores are more comparable.
A score of 3 or more is common in real practice, so the result works best as a screening flag rather than as a diagnosis.
Ask the bed partner about observed apneas — patients themselves are often unaware of their breathing pauses during sleep.
If surgery is planned, the score is best read alongside the rest of the anesthesia and airway assessment.
Rescreen after weight loss — significant weight reduction can lower the STOP-BANG score and reduce OSA severity.

What the Score Can and Cannot Do

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.

Why the Same Questions Matter in Different Settings

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.

Reading the Result Carefully

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.

Sources & Methodology

Last updated: March 28, 2026

Methodology

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.

Sources

Validation of the STOP-Bang Questionnaire among Patients Referred for Suspected Obstructive Sleep Apnea (PubMed) — Clinical validation paper supporting STOP-BANG screening use.
Obstructive sleep apnea screening and assessment (Mayo Clinic) — General screening context and follow-up discussion reference.
Obstructive Sleep Apnea (NHLBI) — Public health overview of OSA screening and diagnosis context.

Frequently Asked Questions

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.