Screening scores

STOP-Bang Sleep Apnea Screener

STOP-Bang is a widely used screening questionnaire for obstructive sleep apnea, developed by Dr. Frances Chung and colleagues at the University of Toronto. The name stands for Snoring, Tiredness, Observed apnea, Pressure, BMI, Age, Neck size and Gender. Each yes counts one point. The questions below are paraphrased. A higher score means a higher chance of moderate to severe sleep apnea, and a score of 3 or more is usually a reason to talk to a clinician about testing.

Do you snore loudly (loud enough to be heard through a closed door or for a bed partner to complain)? Do you often feel tired, fatigued or sleepy during the day? Has anyone seen you stop breathing, choke or gasp during sleep? Do you have, or are you being treated for, high blood pressure? Is your BMI more than 35? Are you older than 50? Is your neck circumference more than 40 cm (about 16 inches)? Are you male?

STOP-Bang score (0 to 8)

STOP items answered yes (0 to 4)

Estimated risk of obstructive sleep apnea

How it works

Each yes answer is 1 point, for a total of 0 to 8. The published bands are 0 to 2 low risk, 3 to 4 intermediate risk and 5 to 8 high risk. The STOP-Bang authors also describe a step for mid range scores: a score of 3 or 4 is reclassified as high risk when at least 2 of the 4 STOP questions are yes and the person is male, has a BMI over 35 or has a large neck.

Example

A 56 year old man who snores loudly and has high blood pressure, with a 42 cm neck and a BMI of 31: snoring 1, pressure 1, age 1, neck 1, male 1 = 5 points, high risk.

Assumptions and limits

This is a screening and education aid, not a diagnosis. Only a clinician, usually with a sleep test, can diagnose a sleep disorder.
Questions are paraphrased from the original STOP-Bang questionnaire (Chung et al., Anesthesiology 2008), which is available free from stopbang.ca for noncommercial use.
The original version uses a neck cutoff of 40 cm; a later version uses sex specific cutoffs (43 cm for men, 41 cm for women).
STOP-Bang is designed to be sensitive, so it flags many people who turn out not to have significant sleep apnea. A low score does not rule out sleep apnea if you have symptoms.
It was validated in adults; it is not for children.

Frequently asked questions

What should I do with a high score?

Share the result with your doctor. Sleep apnea is diagnosed with a sleep study, either a home sleep apnea test or an overnight study in a sleep lab. Untreated moderate to severe sleep apnea is linked with high blood pressure, heart disease, stroke and drowsy driving crashes.

Can I have sleep apnea with a low score?

Yes. Screening questionnaires miss some cases, particularly in women, younger people and people who are not overweight. If you have symptoms like witnessed breathing pauses or unrefreshing sleep, ask about testing regardless of the score.

How do I measure my neck?

Use a soft tape measure around the neck just below the Adams apple, standing upright and looking straight ahead. 40 cm is about 15.75 inches.

How do I find my BMI?

BMI is weight in kilograms divided by height in meters squared. Use the BMI calculator on this site, then answer the BMI question here.

Sources

Tools and screening scores are general information. They cannot diagnose or rule out a sleep disorder. Read our medical disclaimer.