Clinical Definition

The STOP-BANG questionnaire is an eight-item, yes-or-no screening tool designed for identifying individuals at high risk of having moderate to severe obstructive sleep apnea. The acronym stands for the eight risk factors assessed:

  • Snoring: Do you snore loudly?
  • Tired: Do you often feel tired, fatigued, or sleepy during the daytime?
  • Observed: Has anyone observed you stop breathing during your sleep?
  • Pressure: Do you have or are you being treated for high blood pressure?
  • BMI: Is your Body Mass Index more than 35 kg/m²?
  • Age: Are you over 50 years old?
  • Neck: Is your neck circumference greater than 40 cm (16 inches)?
  • Gender: Are you male?

Each "yes" answer receives one point, for a total possible score of 8.

Etymology & History

The questionnaire was developed by Dr. Frances Chung and colleagues at the Toronto Western Hospital in Canada and was first published in 2008. It was designed primarily for use in the preoperative setting to identify patients at risk for perioperative complications related to undiagnosed OSA.
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Reference Values & Interpretation

Normal Values

There is no "normal" score. It is a risk assessment tool. A low score indicates low risk.

Abnormal Values

  • Low Risk: Score of 0-2
  • Intermediate Risk: Score of 3-4
  • High Risk: Score of 5-8

A score ≥ 3 has a high sensitivity for detecting any OSA (AHI > 5), while a score ≥ 5 is highly sensitive for moderate to severe OSA (AHI > 15).

How It's Measured

The STOP-BANG is a self-administered or clinician-administered questionnaire. BMI, age, neck circumference, and gender are objective measures, while snoring, tiredness, observed apneas, and blood pressure are based on patient (or bed partner) report and history.

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Role in Diagnosis

A high-risk score on the STOP-BANG questionnaire is a strong indication for further diagnostic evaluation with a sleep study. Its high sensitivity makes it an excellent tool to "rule out" OSA in low-risk patients, especially in a preoperative setting.

Role in Treatment

While not used to guide treatment directly, a high STOP-BANG score can add urgency to initiating treatment once OSA is confirmed. It helps identify patients who are at higher risk for the negative health consequences of untreated OSA.

Associated Conditions

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Clinical Guidelines

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Latest Research & Updates

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The STOP-BANG tool has been validated in numerous studies and diverse populations, including surgical patients, sleep clinic patients, and the general population. Its high negative predictive value means that a low score is very effective at ruling out moderate-to-severe OSA.