STOP-BANG Sleep Apnea Risk Calculator

Complete this validated 8-question screening tool to assess your risk of obstructive sleep apnea and get personalized recommendations.

The STOP-BANG questionnaire is a widely used screening tool that helps identify individuals at risk for obstructive sleep apnea. Answer 8 simple questions to determine your risk level.

STOP-BANG Examples

Click on any example to load it into the calculator.

Low Risk Individual

low_risk

A young, healthy individual with minimal sleep apnea risk factors.

Snoring: No

Tired: No

Observed: No

Blood Pressure: No

BMI: No

Age: No

Neck Circumference: No

Gender: No

Intermediate Risk Individual

intermediate_risk

An individual with some risk factors requiring further evaluation.

Snoring: Yes

Tired: Yes

Observed: No

Blood Pressure: No

BMI: No

Age: Yes

Neck Circumference: No

Gender: Yes

High Risk Individual

high_risk

An individual with multiple risk factors indicating high sleep apnea risk.

Snoring: Yes

Tired: Yes

Observed: Yes

Blood Pressure: Yes

BMI: Yes

Age: Yes

Neck Circumference: Yes

Gender: Yes

Moderate Risk Individual

moderate_risk

An individual with moderate risk factors requiring medical attention.

Snoring: Yes

Tired: Yes

Observed: No

Blood Pressure: No

BMI: No

Age: Yes

Neck Circumference: No

Gender: Yes

Other Titles
Understanding STOP-BANG Calculator: A Comprehensive Guide
Master the science of sleep apnea risk assessment using the validated STOP-BANG questionnaire. Learn how this screening tool works, its clinical significance, and how to interpret results for better sleep health.

What is the STOP-BANG Questionnaire?

  • Definition and Purpose
  • Clinical Validation
  • Global Health Significance
The STOP-BANG questionnaire is a validated screening tool designed to identify individuals at risk for obstructive sleep apnea (OSA). Developed by researchers at the University of Toronto, this simple 8-question assessment has become a standard screening method used worldwide by healthcare providers to quickly evaluate sleep apnea risk. The acronym STOP-BANG represents the eight key risk factors: Snoring, Tired, Observed apnea, Pressure (blood pressure), BMI, Age, Neck circumference, and Gender.
The Scientific Foundation of STOP-BANG
The STOP-BANG questionnaire was developed through extensive clinical research involving thousands of patients undergoing sleep studies. Each question targets specific risk factors that have been scientifically proven to correlate with obstructive sleep apnea. The tool uses a simple scoring system where each 'Yes' answer contributes one point, with total scores ranging from 0 to 8. This scoring system has been validated against gold-standard sleep studies (polysomnography) and has demonstrated high sensitivity and specificity for detecting moderate to severe sleep apnea.
Clinical Validation and Accuracy
Multiple studies have validated the STOP-BANG questionnaire across diverse populations and clinical settings. The tool has shown sensitivity rates of 83-100% for detecting moderate to severe OSA, making it an excellent screening instrument. Its specificity ranges from 37-56%, which is acceptable for a screening tool designed to identify individuals who should undergo further evaluation. The questionnaire has been validated in various languages and cultural contexts, making it applicable for global use in sleep medicine practice.
Global Health Applications and Standards
The STOP-BANG questionnaire has been adopted by major sleep medicine organizations worldwide, including the American Academy of Sleep Medicine, European Respiratory Society, and various national sleep societies. It serves as a crucial first-line screening tool in primary care settings, preoperative evaluations, and sleep clinics. The questionnaire's simplicity and accessibility make it particularly valuable in resource-limited settings where access to sleep laboratories may be limited.

STOP-BANG Risk Categories:

  • Low Risk (0-2 points): Unlikely to have moderate to severe OSA
  • Intermediate Risk (3-4 points): Moderate probability of OSA, consider further evaluation
  • High Risk (5-8 points): High probability of moderate to severe OSA, recommend sleep study

Step-by-Step Guide to Using the STOP-BANG Calculator

  • Question Interpretation
  • Scoring Methodology
  • Result Analysis and Action
Accurate STOP-BANG assessment requires careful consideration of each question and honest self-evaluation. Follow this comprehensive methodology to ensure your risk assessment provides meaningful insights for sleep health management.
1. Understanding Each STOP-BANG Question
Each question in the STOP-BANG questionnaire targets specific risk factors for obstructive sleep apnea. The 'S' (Snoring) question identifies individuals with loud snoring, a primary symptom of OSA. The 'T' (Tired) question screens for excessive daytime sleepiness, a key consequence of poor sleep quality. The 'O' (Observed) question captures witnessed apneas, which are highly specific for OSA. The 'P' (Pressure) question identifies hypertension, a common comorbidity of sleep apnea. The 'B' (BMI) question screens for obesity, a major risk factor. The 'A' (Age) question identifies older adults at higher risk. The 'N' (Neck) question screens for large neck circumference, associated with airway obstruction. The 'G' (Gender) question acknowledges that men are at higher risk than women.
2. Accurate Self-Assessment and Scoring
When completing the STOP-BANG questionnaire, provide honest answers based on your current situation. For the snoring question, consider feedback from bed partners or family members. For tiredness, evaluate your typical daytime energy levels and tendency to fall asleep in inappropriate situations. For observed apneas, rely on reports from bed partners or family members who may have witnessed breathing pauses. For blood pressure, consider both diagnosed hypertension and elevated readings. For BMI, use recent measurements or estimates. For age, use your current age. For neck circumference, measure around the narrowest part of your neck. For gender, answer based on your biological sex.
3. Interpreting Your STOP-BANG Score
Your STOP-BANG score determines your risk category for obstructive sleep apnea. A score of 0-2 indicates low risk, with less than 20% probability of moderate to severe OSA. A score of 3-4 indicates intermediate risk, with 20-40% probability of moderate to severe OSA. A score of 5-8 indicates high risk, with 60-80% probability of moderate to severe OSA. However, remember that the STOP-BANG is a screening tool, not a diagnostic test. Your score should guide decisions about further evaluation rather than providing a definitive diagnosis.
4. Taking Action Based on Results
If your STOP-BANG score indicates low risk, continue monitoring your sleep health and maintain healthy sleep habits. If your score indicates intermediate risk, consider lifestyle modifications such as weight loss, sleep position changes, and avoiding alcohol before bedtime. Consult with your healthcare provider about whether further evaluation is needed. If your score indicates high risk, schedule an appointment with a sleep medicine specialist for comprehensive evaluation, which may include a sleep study (polysomnography) to confirm or rule out OSA.

STOP-BANG Interpretation Guidelines:

  • Score 0-2: Low risk - maintain healthy sleep habits, monitor for new symptoms
  • Score 3-4: Intermediate risk - consider lifestyle changes, discuss with healthcare provider
  • Score 5-8: High risk - seek medical evaluation, consider sleep study referral

Real-World Applications and Clinical Significance

  • Primary Care Screening
  • Preoperative Assessment
  • Sleep Medicine Practice
The STOP-BANG questionnaire serves as a critical screening tool across multiple healthcare settings, providing valuable insights for clinical decision-making, patient safety, and sleep health management.
Primary Care and General Practice
Primary care providers use the STOP-BANG questionnaire as a routine screening tool during annual physical examinations and wellness visits. The questionnaire helps identify patients who may have undiagnosed sleep apnea, allowing for early intervention and prevention of complications. In primary care settings, the STOP-BANG serves as a conversation starter about sleep health and can lead to important discussions about lifestyle modifications, weight management, and sleep hygiene. The tool's simplicity makes it practical for busy primary care practices where time is limited.
Preoperative Assessment and Surgical Safety
The STOP-BANG questionnaire is widely used in preoperative assessments to identify patients at risk for perioperative complications related to undiagnosed sleep apnea. Patients with high STOP-BANG scores may require special monitoring during and after surgery, including continuous pulse oximetry and careful pain medication management. The questionnaire helps anesthesiologists and surgeons make informed decisions about postoperative care and discharge planning. This screening is particularly important for patients undergoing major surgeries where undiagnosed OSA could pose significant risks.
Sleep Medicine and Specialty Care
Sleep medicine specialists use the STOP-BANG questionnaire as part of comprehensive sleep evaluations. The questionnaire helps prioritize patients for sleep studies and guides decisions about the type and urgency of further testing. In sleep clinics, the STOP-BANG score is often combined with other clinical information, such as medical history, physical examination findings, and other sleep questionnaires, to develop comprehensive treatment plans. The tool also helps track changes in sleep apnea risk over time and assess the effectiveness of interventions.

Clinical Applications by Setting:

  • Primary Care: Routine screening, sleep health education, lifestyle counseling
  • Preoperative: Risk assessment, perioperative planning, safety protocols
  • Sleep Medicine: Comprehensive evaluation, treatment planning, outcome monitoring

Understanding Obstructive Sleep Apnea and Risk Factors

  • Pathophysiology
  • Health Consequences
  • Risk Factor Mechanisms
Understanding the underlying mechanisms of obstructive sleep apnea and how STOP-BANG risk factors contribute to the condition is essential for accurate interpretation of screening results and appropriate clinical decision-making.
Pathophysiology of Obstructive Sleep Apnea
Obstructive sleep apnea occurs when the upper airway collapses or becomes blocked during sleep, causing breathing to stop temporarily. This airway obstruction typically results from a combination of anatomical and physiological factors. Anatomical factors include enlarged tonsils, adenoids, or tongue; narrow airway due to jaw structure; or excess tissue in the throat. Physiological factors include reduced muscle tone during sleep, which allows the airway to collapse more easily. When breathing stops, oxygen levels drop, and the brain briefly awakens to restore breathing, leading to fragmented sleep and daytime symptoms.
Health Consequences of Untreated Sleep Apnea
Untreated obstructive sleep apnea can have serious health consequences. Cardiovascular complications include hypertension, heart disease, stroke, and arrhythmias. Metabolic effects include insulin resistance, type 2 diabetes, and metabolic syndrome. Neurological consequences include cognitive impairment, memory problems, and increased risk of accidents due to daytime sleepiness. Psychological effects include depression, anxiety, and mood disorders. The condition also affects quality of life through poor sleep quality, relationship problems due to snoring, and decreased work performance. Early identification through screening tools like STOP-BANG can prevent these complications.
Mechanisms of STOP-BANG Risk Factors
Each STOP-BANG risk factor contributes to sleep apnea through specific mechanisms. Snoring indicates airway narrowing and increased resistance to airflow. Daytime tiredness reflects sleep fragmentation and poor sleep quality. Observed apneas directly indicate the presence of breathing pauses. High blood pressure is both a consequence and risk factor for OSA due to sympathetic nervous system activation. High BMI contributes through increased fat deposition around the airway and reduced lung volumes. Age-related changes include decreased muscle tone and increased airway collapsibility. Large neck circumference indicates increased soft tissue around the airway. Male gender is associated with different fat distribution patterns and airway anatomy.

Risk Factor Mechanisms:

  • Snoring: Airway narrowing, increased resistance, vibration of soft tissues
  • Obesity: Fat deposition around airway, reduced lung volumes, altered breathing mechanics
  • Age: Decreased muscle tone, increased airway collapsibility, anatomical changes

Limitations and Considerations of STOP-BANG Screening

  • Screening vs Diagnosis
  • Population Variations
  • Alternative Assessment Methods
While the STOP-BANG questionnaire is a valuable screening tool, understanding its limitations is crucial for appropriate clinical interpretation and avoiding over-reliance on screening results alone.
Screening Limitations and False Results
The STOP-BANG questionnaire, like all screening tools, has limitations that must be considered. False-positive results can occur when individuals have risk factors but do not actually have sleep apnea, leading to unnecessary anxiety and medical evaluations. False-negative results can occur when individuals have sleep apnea but score low on the questionnaire, potentially delaying diagnosis and treatment. The questionnaire's sensitivity and specificity vary across different populations, with some studies showing lower accuracy in certain ethnic groups or age categories. Additionally, the questionnaire relies on self-reporting, which can be influenced by awareness, memory, and willingness to report symptoms.
Population Variations and Cultural Considerations
The STOP-BANG questionnaire was developed primarily in Western populations, and its accuracy may vary in different ethnic and cultural groups. Some populations may have different body composition patterns, airway anatomy, or sleep habits that affect the relevance of certain questions. Cultural factors may influence how individuals interpret and respond to questions about snoring, sleepiness, or observed apneas. Language barriers and translation issues can also affect questionnaire accuracy. Healthcare providers should consider these factors when interpreting STOP-BANG results in diverse populations and may need to adjust thresholds or use additional clinical judgment.
Complementary Assessment Methods
The STOP-BANG questionnaire should be used as part of a comprehensive sleep evaluation rather than as a standalone diagnostic tool. Additional assessment methods include detailed sleep history, physical examination focusing on airway anatomy, and other validated questionnaires such as the Epworth Sleepiness Scale or Berlin Questionnaire. Home sleep apnea testing and in-laboratory polysomnography provide objective measures of sleep apnea severity. Clinical judgment and consideration of individual circumstances are essential for appropriate interpretation and management decisions.

Screening Considerations:

  • False Positives: Risk factors present but no actual sleep apnea
  • False Negatives: Sleep apnea present but low screening score
  • Cultural Factors: Different interpretations across populations