STOP-BANG Obstructive Sleep Apnea Screening Questionnaire
Also known as: STOP-BANG OSA Screening
The STOP-BANG is an 8-item screening tool for identifying patients at risk of obstructive sleep apnea (OSA) before surgery or medical procedures. Developed by Chung and colleagues in 2008, it is widely used in perioperative medicine, primary care, and sleep clinics to quickly stratify OSA risk in both adult patients. The tool demonstrates strong sensitivity for moderate to severe OSA, making it valuable in settings where formal sleep testing is impractical.
Key highlights
- High sensitivity (~90%) for moderate-to-severe OSA detection; few OSA cases missed when score ≥5
- Simple 8-item format with memorable acronym; takes 2–3 minutes to complete
- Combines subjective symptoms (snoring, tiredness) with objective factors (age, BMI, neck size); robust across demographic groups
- Validated across multiple languages and healthcare settings; strong evidence base in perioperative medicine
- Free to use; no licensing or scoring software required; practical for any clinic, hospital, or emergency setting
Intuition
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How it works
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When to use it
STOP-BANG is indicated for pre-operative OSA screening in any patient undergoing elective surgery or procedures requiring anesthesia. Also appropriate in primary care visits to screen for undiagnosed OSA, emergency departments triaging patients with respiratory complaints, and sleep clinics confirming clinical suspicion. The tool is most useful in populations with high OSA prevalence: middle-aged and older adults, patients with obesity, men, and those with treated or untreated hypertension. Not intended as a diagnostic test; positive screens require formal sleep study (polysomnography) for definitive diagnosis.
Strengths & limitations
- High sensitivity (~90%) for moderate-to-severe OSA detection; few OSA cases missed when score ≥5
- Simple 8-item format with memorable acronym; takes 2–3 minutes to complete
- Combines subjective symptoms (snoring, tiredness) with objective factors (age, BMI, neck size); robust across demographic groups
- Validated across multiple languages and healthcare settings; strong evidence base in perioperative medicine
- Free to use; no licensing or scoring software required; practical for any clinic, hospital, or emergency setting
- Specificity is moderate (~43%); high false-positive rate means many patients with positive scores do not have clinically significant OSA
- Relies on patient self-report of symptoms; patients may not accurately recall snoring history or daytime sleepiness severity
- Cannot differentiate OSA severity; only indicates risk category, not apnea-hypopnea index (AHI) or oxygen desaturation episodes
- Does not account for anatomical factors (crowded oropharynx, retrognathia) or neuromuscular conditions that contribute to OSA
- Not validated in children; designed for adult populations age ≥18 years
Common pitfalls
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Frequently asked
What is the minimum score that warrants action?
A score of 3 or higher suggests intermediate-to-high OSA risk. Scores 3–4 warrant heightened clinical vigilance and patient counseling; scores ≥5 strongly recommend formal sleep evaluation. Even scores of 0–2 do not exclude OSA, particularly in symptomatic patients.
Can STOP-BANG be used to diagnose sleep apnea?
No. STOP-BANG screens for OSA risk and indicates the probability of moderate-to-severe disease if present. Definitive diagnosis requires polysomnography (in-lab or home sleep test) showing ≥5 apnea-hypopnea events per hour (AHI ≥5/hour).
How reliable is patient reporting of snoring and apnea?
Patient recall of snoring is often inaccurate, especially if sleeping alone. Ideally, ask a bed partner to confirm snoring and observed apnea episodes. If a bed partner is unavailable, interpret responses conservatively and consider other STOP-BANG items more heavily.
Does a low STOP-BANG score rule out OSA?
No. While sensitivity is high (~90%), low scores do not exclude OSA in symptomatic patients. If clinical suspicion remains high (e.g., patient reports severe daytime sleepiness despite low score), sleep evaluation may still be indicated.
Sources
- 1.Chung, F., Yegneswaran, B., Liao, P., et al. (2008). STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology, 108(5), 812-821.
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Cite this page
ScholarGate. (2026, June 3). STOP-BANG. ScholarGate. https://scholargate.app/sleep-medicine/stop-bang-questionnaire