What is the Stop-Bang (Stop-Bang screening tool for obstructive sleep apnea)?

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Last updated: March 21, 2025View editorial policy

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From the Guidelines

The STOP-BANG screening tool is a widely used questionnaire to identify individuals at risk for obstructive sleep apnea (OSA), consisting of eight yes/no questions that evaluate snoring, tiredness, observed apnea, high blood pressure, body mass index, age, neck circumference, and gender. The tool is effective in assessing multiple risk factors associated with sleep apnea, including anatomical features, symptoms, and demographic factors that contribute to upper airway obstruction during sleep 1. The STOP-BANG questionnaire has high sensitivity but low specificity for detecting OSA, making it a useful screening tool but not a definitive diagnostic instrument 1.

Key Components of the STOP-BANG Questionnaire

  • Snoring: yes/no
  • Tiredness: yes/no
  • Observed apnea: yes/no
  • High blood Pressure: yes/no
  • Body mass index: yes/no (typically >35)
  • Age: yes/no (typically >50)
  • Neck circumference: yes/no (typically >40 cm)
  • Gender: yes/no (male)

Interpretation of STOP-BANG Scores

  • A score of 0-2 indicates low risk for OSA
  • A score of 3-4 suggests intermediate risk
  • A score of 5-8 indicates high risk

Healthcare providers use the STOP-BANG questionnaire during pre-operative assessments or in primary care settings to determine if patients need further sleep testing 1. Early identification of OSA is crucial because untreated sleep apnea can lead to serious health complications, including cardiovascular disease, stroke, and diabetes. While the STOP-BANG questionnaire is not a definitive diagnostic tool, it is a valuable screening instrument for identifying individuals at risk for OSA, and its use is supported by clinical practice guidelines 1.

From the Research

Overview of the Stop-Bang Screening Tool

  • The Stop-Bang screening tool is a questionnaire used to screen for obstructive sleep apnea (OSA) 2, 3, 4, 5, 6.
  • It consists of eight yes-or-no questions that assess various risk factors for OSA, including snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck size, and gender 2, 3, 4, 5.

Components of the Stop-Bang Questionnaire

  • The eight components of the Stop-Bang questionnaire are:
    • S: Snoring
    • T: Tiredness
    • O: Observed apnea
    • P: Blood pressure
    • B: Body mass index
    • A: Age
    • N: Neck size
    • G: Gender 2, 3, 4, 5

Scoring and Interpretation

  • A score of 3 or more out of 8 indicates a high risk of OSA 2, 3, 4, 5.
  • The sensitivity and specificity of the Stop-Bang questionnaire vary depending on the population and the cutoff value used 3, 4, 5, 6.
  • Studies have shown that the Stop-Bang questionnaire has high sensitivity and moderate specificity for detecting OSA, particularly in sleep clinic and surgical populations 2, 3, 5.

Application and Validation

  • The Stop-Bang questionnaire has been validated in various populations, including sleep clinic patients, surgical patients, and Asian populations 2, 3, 4, 5.
  • It has been shown to be a useful and easy-to-use tool for screening for OSA, with high sensitivity and moderate specificity 2, 3, 4, 5.
  • Combining the Stop-Bang questionnaire with other screening tools, such as the Epworth Sleepiness Scale, may improve its specificity and accuracy in predicting OSA 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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