STOP-BANG Calculator

Q: What is the STOP-BANG questionnaire and what does it screen for?

The STOP-BANG questionnaire is a validated screening tool for obstructive sleep apnea (OSA) developed by Dr. Frances Chung at the University of Toronto in 2008. The acronym stands for eight binary (yes/no) risk factors: Snoring, Tiredness, Observed apneas, high blood Pressure, BMI over 35, Age over 50, Neck circumference over 40 cm, and male Gender. Each positive answer scores 1 point, for a total

Q: How are STOP-BANG scores interpreted for OSA risk?

STOP-BANG scores are categorized into three risk levels for moderate-to-severe obstructive sleep apnea. A score of 0 to 2 indicates low risk, with less than 10 percent probability of moderate-to-severe OSA. A score of 3 to 4 indicates intermediate risk, with approximately 25 to 35 percent probability. A score of 5 to 8 indicates high risk, with greater than 50 percent probability of moderate-to-se

Q: Why is STOP-BANG used for preoperative screening?

Preoperative STOP-BANG screening is critical because undiagnosed obstructive sleep apnea significantly increases perioperative complications. Patients with undiagnosed OSA face a 2 to 4 times higher risk of postoperative respiratory complications including difficult intubation, oxygen desaturation, reintubation, and unplanned ICU admission. Sedatives, anesthetics, and opioid pain medications relax

Q: How accurate is the STOP-BANG questionnaire compared to other screening tools?

The STOP-BANG questionnaire has been extensively validated and demonstrates superior sensitivity compared to other OSA screening tools. For detecting moderate-to-severe OSA (AHI >= 15), STOP-BANG has a sensitivity of 90 to 100 percent at a cutoff score of 3, meaning it catches nearly all cases. Its specificity is lower (25 to 45 percent), meaning some people without OSA will screen positive. Compa

Use our free Stopbangcalculator Calculator to get personalized health results. Based on validated medical formulas and clinical guidelines.

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Formula

STOP-BANG Score = Sum of 8 binary criteria (0 or 1 each, max 8)

Eight yes/no criteria: Snoring (loud), Tired (daytime fatigue), Observed apneas, blood Pressure (treated hypertension), BMI > 35, Age > 50, Neck > 40 cm, Gender (male). Score 0-2: Low risk, 3-4: Intermediate risk, 5-8: High risk for moderate-to-severe OSA.

Worked Examples

Example 1: High-Risk Preoperative Patient

Problem: A 55-year-old male scheduled for knee surgery: loud snoring, daytime tiredness, wife observed apneas, on BP medication, BMI 38, neck 17 inches. Calculate STOP-BANG.

Solution: S - Snoring: YES (1)\nT - Tired: YES (1)\nO - Observed apneas: YES (1)\nP - Blood Pressure treatment: YES (1)\nB - BMI 38 > 35: YES (1)\nA - Age 55 > 50: YES (1)\nN - Neck 17 in = 43.2 cm > 40: YES (1)\nG - Male Gender: YES (1)\nTotal Score: 8/8

Result: STOP-BANG: 8/8 | High Risk for OSA | Sleep study before elective surgery recommended

Example 2: Low-Risk Female Patient

Problem: A 35-year-old female: no snoring, occasional tiredness, no observed apneas, normal BP, BMI 24, neck 13.5 inches. Calculate STOP-BANG.

Solution: S - Snoring: NO (0)\nT - Tired: NO (0)\nO - Observed apneas: NO (0)\nP - Blood Pressure: NO (0)\nB - BMI 24 <= 35: NO (0)\nA - Age 35 <= 50: NO (0)\nN - Neck 13.5 in = 34.3 cm <= 40: NO (0)\nG - Female Gender: NO (0)\nTotal Score: 0/8

Result: STOP-BANG: 0/8 | Low Risk for OSA | No further sleep evaluation needed

Frequently Asked Questions

What is the STOP-BANG questionnaire and what does it screen for?

The STOP-BANG questionnaire is a validated screening tool for obstructive sleep apnea (OSA) developed by Dr. Frances Chung at the University of Toronto in 2008. The acronym stands for eight binary (yes/no) risk factors: Snoring, Tiredness, Observed apneas, high blood Pressure, BMI over 35, Age over 50, Neck circumference over 40 cm, and male Gender. Each positive answer scores 1 point, for a total of 0 to 8. It was originally developed for preoperative screening of surgical patients but is now widely used in primary care and sleep medicine. The questionnaire takes less than 2 minutes to complete and has been validated in multiple languages and populations worldwide.

How are STOP-BANG scores interpreted for OSA risk?

STOP-BANG scores are categorized into three risk levels for moderate-to-severe obstructive sleep apnea. A score of 0 to 2 indicates low risk, with less than 10 percent probability of moderate-to-severe OSA. A score of 3 to 4 indicates intermediate risk, with approximately 25 to 35 percent probability. A score of 5 to 8 indicates high risk, with greater than 50 percent probability of moderate-to-severe OSA and greater than 70 percent probability of at least mild OSA. Additional high-risk criteria include a STOP score of 2 or more combined with either male gender, BMI over 35, or neck circumference over 40 cm. The sensitivity of STOP-BANG for moderate-to-severe OSA at a cutoff of 3 exceeds 90 percent.

Why is STOP-BANG used for preoperative screening?

Preoperative STOP-BANG screening is critical because undiagnosed obstructive sleep apnea significantly increases perioperative complications. Patients with undiagnosed OSA face a 2 to 4 times higher risk of postoperative respiratory complications including difficult intubation, oxygen desaturation, reintubation, and unplanned ICU admission. Sedatives, anesthetics, and opioid pain medications relax the upper airway and depress respiratory drive, worsening sleep apnea during and after surgery. The American Society of Anesthesiologists recommends preoperative OSA screening for all surgical patients. High-risk patients identified by STOP-BANG may benefit from preoperative CPAP therapy, modified anesthetic techniques, enhanced postoperative monitoring, and careful opioid management to reduce complications.

How accurate is the STOP-BANG questionnaire compared to other screening tools?

The STOP-BANG questionnaire has been extensively validated and demonstrates superior sensitivity compared to other OSA screening tools. For detecting moderate-to-severe OSA (AHI >= 15), STOP-BANG has a sensitivity of 90 to 100 percent at a cutoff score of 3, meaning it catches nearly all cases. Its specificity is lower (25 to 45 percent), meaning some people without OSA will screen positive. Compared to the Berlin Questionnaire (sensitivity 69 to 87 percent), STOP questionnaire alone (sensitivity 74 to 83 percent), and the Epworth Sleepiness Scale (sensitivity 27 to 66 percent), STOP-BANG consistently demonstrates the highest sensitivity. The trade-off of high sensitivity for lower specificity is appropriate for a screening tool because missing cases (false negatives) is more dangerous than over-referring for sleep studies.

What should I do if my STOP-BANG score indicates high risk?

A high-risk STOP-BANG score (5 or above) should prompt several important next steps. First, schedule an appointment with your primary care physician or directly with a sleep medicine specialist to discuss your results and symptoms. Your doctor will likely order a diagnostic sleep study, either an in-laboratory polysomnography or a home sleep apnea test, to confirm the diagnosis and determine severity. In the interim, avoid sleeping on your back (supine position), limit alcohol consumption especially before bedtime, and avoid sedative medications when possible. If diagnosed with OSA, treatment options include CPAP therapy, oral appliance therapy, weight loss, positional therapy, and in some cases surgical interventions. Do not delay evaluation, as untreated OSA significantly increases cardiovascular and accident risks.

Can the STOP-BANG questionnaire be used in children or adolescents?

The STOP-BANG questionnaire was developed and validated exclusively for adult populations and is not appropriate for use in children or adolescents under 18 years of age. Pediatric OSA has different risk factors, diagnostic thresholds, and underlying mechanisms compared to adult OSA. In children, the primary risk factor is adenotonsillar hypertrophy rather than obesity, and the AHI diagnostic threshold is 1 event per hour rather than 5. Pediatric screening tools include the Pediatric Sleep Questionnaire (PSQ) and the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire, both specifically validated for children. For adolescents transitioning to adult care, the STOP-BANG may become applicable at age 18, but clinicians should use clinical judgment when applying adult screening tools to older adolescents.