STOP-BANG Questionnaire: What Your Score Means
⚡ Key Clinical Takeaways
- STOP-BANG was developed to identify people who are at risk for obstructive sleep apnea, especially before surgery or in busy clinical settings.
- Some versions add a question about observed choking or gasping.
- Give yourself one point for each yes.
- A low score does not rule out apnea.
- STOP-BANG relies on self-report and simple measurements.
Quick answer: STOP-BANG is an eight-item screening questionnaire for obstructive sleep apnea risk. Each item is a yes or no, and the total ranges from 0 to 8. A score of 0 to 2 is generally low risk, 3 to 4 is intermediate, and 5 or more is high risk. It is a screening tool, not a diagnosis; a sleep study is still needed to confirm apnea.
The name is a memory aid. STOP stands for Snoring, Tiredness, Observed apnea, and Pressure. BANG stands for BMI, Age, Neck circumference, and Gender. The questions are quick, which is why the tool is used in preoperative clinics, primary care, and sleep centers.
What STOP-BANG is for
STOP-BANG was developed to identify people who are at risk for obstructive sleep apnea, especially before surgery or in busy clinical settings. It is not designed to diagnose apnea or to measure its severity. It is designed to flag people who should be evaluated further.
The questionnaire is particularly useful when a full sleep history is not practical. A high score can prompt a referral, a sleep study, or a preoperative anesthesia review.
The eight items
- S — Snoring: Do you snore loudly, loud enough to be heard through a closed door?
- T — Tiredness: Do you often feel tired or sleepy during the daytime?
- O — Observed apnea: Has anyone observed you stop breathing during sleep?
- P — Pressure: Do you have high blood pressure, or are you being treated for it?
- B — BMI: Is your body mass index greater than 35?
- A — Age: Are you older than 50?
- N — Neck circumference: Is your neck circumference greater than 16 inches for a woman or 17 inches for a man?
- G — Gender: Are you male?
Some versions add a question about observed choking or gasping. The original scoring uses the eight items above.
How to score it
Give yourself one point for each yes. The total is your score. The usual risk bands are:
| Score | Risk level |
|---|---|
| 0 to 2 | Low risk |
| 3 to 4 | Intermediate risk |
| 5 to 8 | High risk |
Some clinicians use a lower threshold for women or for people with symptoms. The score is a starting point, not a fixed verdict.
What the score means
A low score does not rule out apnea. A thin, young woman with apnea can score low, especially if the only symptom is fatigue. A high score does not prove apnea. A muscular man with a thick neck, high BMI, and loud snoring may score high without having significant apnea.
The score is most useful when combined with the clinical picture. If the score is high and the person has witnessed pauses, gasping, or daytime sleepiness, the pretest probability is higher. If the score is high but there are no symptoms, the clinician may still test, but the interpretation is different.
Limits of the questionnaire
STOP-BANG relies on self-report and simple measurements. It does not capture the full range of symptoms, such as morning headaches, nocturia, or mood changes. It does not distinguish obstructive from central apnea. It does not measure severity.
The BMI and neck circumference cutoffs are population-based. They may not fit every body type or ethnic group. The age cutoff is a blunt instrument. The gender item reflects the higher risk in men, but it can contribute to the underdiagnosis of apnea in women.
What to do with a high score
Talk to a clinician about a sleep evaluation. Bring the score, a sleep diary, and a list of medications. If you are scheduled for surgery, tell the anesthesia team; undiagnosed apnea can affect anesthesia and recovery. If you drive commercially or operate heavy machinery, mention the sleepiness.
Do not use the score to self-diagnose or to decide on treatment. A sleep study is the next step if testing is indicated.
STOP-BANG vs Epworth
STOP-BANG estimates the risk of sleep apnea. The Epworth Sleepiness Scale measures daytime sleepiness. They answer different questions. A person can have a high STOP-BANG score and a normal Epworth score, or the reverse.
Used together, they give a fuller picture: risk factors plus the functional impact of sleepiness.
Frequently Asked Questions
What is a normal STOP-BANG score?
A score of 0 to 2 is considered low risk. That does not rule out apnea, especially if symptoms are present.
What does a STOP-BANG score of 3 mean?
A score of 3 is in the intermediate range. It is a reason to discuss testing with a clinician, especially if you have snoring, witnessed pauses, or daytime sleepiness.
Can STOP-BANG diagnose sleep apnea?
No. It is a screening questionnaire. A sleep study is needed to diagnose apnea and measure severity.
Does a low score mean I do not have sleep apnea?
No. Some people with apnea score low, particularly women and people without classic risk factors. Symptoms and clinical judgment still matter.
Is STOP-BANG used before surgery?
Yes. It is often used in preoperative assessments to identify patients who may need closer monitoring or a sleep evaluation.
How is neck circumference measured for STOP-BANG?
Measure around the neck at the level of the Adam's apple, with the tape snug but not tight. The cutoff is greater than 16 inches for women and greater than 17 inches for men.
This article is general information, not medical advice. A screening score cannot diagnose sleep apnea, so talk with a clinician about symptoms and testing.
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This medical guide complies with the American Academy of Sleep Medicine (AASM) standards of care for sleep disorders and reflects generally accepted clinical guidelines. It is informational and not a substitute for personalized medical advice.