STOP-BANG Questionnaire
Screens for obstructive sleep apnea based on symptoms and OSA risk factors.
Refer to the text below the questionnaire for more information about this easy to remember acronym-based screening method for OSA.
The STOP-BANG questionnaire is a widely used screening tool for obstructive sleep apnea. It is addressed to patients with symptoms such as drowsiness, snoring, observer periods of night time apnea or noisy breathing and can also be used as part of the pre-operative assessment.
Scale Items
Snoring? | Body Mass Index |
Tired? (Tired, fatigued, or sleepy during the daytime) | Age |
Observed? (Stop breathing or choking/ gasping during your sleep) | Neck size |
Pressure? (High blood pressure) | Gender |
Interpretation
STOP-BANG score | Obstructive sleep apnea (OSA) |
0 – 2 | Low risk of OSA |
3 – 4 | Intermediate risk of OSA |
5 – 8 | High risk of OSA |
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STOP-BANG Questionnaire Explained
The STOP-BANG questionnaire is a widely used screening tool for obstructive sleep apnea. It is addressed to patients with symptoms such as drowsiness, snoring, observer periods of night time apnea or noisy breathing and can also be used as part of the pre-operative assessment.
Obstructive sleep apnea is caused by the mechanical obstruction of the upper airway, which results in diminished breathing (hypopnea) or elimination of breathing (apnea). Diagnosis after screening may involve polysomnography with continuous positive airway pressure (CPAP) being the first line of treatment.
OSA is a condition with significant morbidity and may result in neurocognitive deficiencies and cardiopulmonary conditions. Perioperative risks associated with OSA may be mitigated by monitoring and potentially CPAP and other treatments.
STOP-Bang has a total of 8 items which form an acronym as follows:
- Snoring?
- Tired? (Tired, fatigued, or sleepy during the daytime)
- Observed? (Stop breathing or choking/ gasping during your sleep)
- Pressure? (High blood pressure)
- Body Mass Index
- Age
- Neck size
- Gender
The administration of the questionnaire takes roughly 5 minutes and each positive answer to the above questions scores 1 point, with total scores ranging from 0 to 8, where:
STOP-BANG score | Obstructive sleep apnea (OSA) |
0 – 2 | Low risk of OSA |
3 – 4 | Intermediate risk of OSA |
5 – 8 | High risk of OSA |
The STOP-BANG score was developed by Chung et al. as a modification of the STOP questions. Through the addition of the BANG assessment, the screening has become more sensitive and with a higher negative predictive value.
According to Chung et al. higher scores on the STOP-Bang were associated with the occurrence of postoperative complications.
Subsequently the screening was validated in multiple settings and found to be an effective screen not only for pre-operative patients but also for the general population.
References
Original references
Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008; 108(5):812-821.
Validation
Chung F, Subramanyam R, Liao P, Sasaki E, Shapiro C, Sun Y. High STOP-Bang score indicates a high probability of obstructive sleep apnoea. Br J Anaesth. 2012; 108(5):768-775.
Nagappa M, Liao P, Wong J, et al. Validation of the STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea among Different Populations: A Systematic Review and Meta-Analysis. PLoS One. 2015; 10(12):e0143697.
Other references
Chung F, Yang Y, Brown R, Liao P. Alternative scoring models of STOP-bang questionnaire improve specificity to detect undiagnosed obstructive sleep apnea. J Clin Sleep Med. 2014; 10(9):951-8.
Uchôa CHG, Danzi-Soares NJ, Nunes FS, et al. Impact of OSA on cardiovascular events after coronary artery bypass surgery. Chest. 2015; 147(5):1352-1360.
Specialty: Pulmonology
Year Of Study: 2008
Article By: Denise Nedea
Published On: July 9, 2020 · 12:00 AM
Last Checked: July 9, 2020
Next Review: July 9, 2025