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

1Snoring Do you Snore Loudly (loud enough to be heard through closed doors or your bed-partner elbows you for snoring at night)?
2Tired Do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleep during driving or talking to someone)?
3Observed Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep?
4Pressure Do you have or are being treated for High Blood Pressure?
5Body Mass Index (BMI) more than 35?
6Age older than 50 year old?
7Neck size large For males: shirt collar 17 in/43 cm or larger | For females: shirt collar 16 in/41 cm or larger
8Severe tonsil inflammation
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Steps on how to print your input & results:

1. Fill in the calculator/tool with your values and/or your answer choices and press Calculate.

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.


 

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