Answer 8 clinically validated STOP-BANG questions to assess your risk for obstructive sleep apnea. Used by sleep clinics worldwide.
Symptoms you experience
Clinical measurements
| Score | Risk Level | Interpretation |
|---|---|---|
| 0 - 2 | Low | Low probability of moderate-to-severe OSA |
| 3 - 4 | Intermediate | Intermediate probability; further factors may elevate risk |
| 5 - 8 | High | High probability of moderate-to-severe OSA; evaluation recommended |
Developed by Dr. Frances Chung at the University of Toronto in 2008, the STOP-BANG questionnaire was designed as a concise, easy-to-administer screening tool for obstructive sleep apnea (OSA) in pre-operative settings. It combines four subjective symptom questions (STOP) with four objective clinical measurements (BANG) to produce a composite risk score. The questionnaire has since been validated across surgical, primary care, and sleep clinic populations worldwide.
In the original validation study of 2,467 surgical patients, STOP-BANG demonstrated a sensitivity of 93.4% for moderate-to-severe OSA (AHI ≥ 15) and 100% sensitivity for severe OSA (AHI ≥ 30). A subsequent meta-analysis by Nagappa et al. (2015) confirmed these findings across multiple populations, establishing STOP-BANG as one of the most sensitive screening instruments available. The tool's high negative predictive value means that a low score (0-2) substantially reduces the probability of clinically significant OSA.
A landmark 2019 global prevalence study by Benjafield et al. estimated that 936 million adults aged 30-69 have mild-to-severe OSA worldwide, with an estimated 80% of moderate-to-severe cases remaining undiagnosed. This underdiagnosis gap makes accessible screening tools like STOP-BANG critically important for identifying at-risk individuals who may benefit from formal sleep evaluation and treatment.
The STOP-BANG questionnaire is a clinically validated screening tool developed by Dr. Frances Chung and colleagues at the University of Toronto in 2008. It was originally designed to identify patients at risk for obstructive sleep apnea (OSA) before surgery, but has since become one of the most widely used OSA screening instruments in primary care, sleep clinics, and population-level health assessments worldwide.
The acronym stands for eight risk factors: Snoring, Tiredness, Observed apnea, blood Pressure, BMI, Age, Neck circumference, and Gender. Each item is scored as yes (1) or no (0), yielding a total between 0 and 8. Its strength lies in combining subjective symptoms (the STOP items) with objective clinical measurements (the BANG factors), providing a more comprehensive risk profile than either alone.
Your score maps to three risk categories. A score of 0 to 2 is classified as low risk, meaning the probability of moderate-to-severe obstructive sleep apnea is relatively small. A score of 3 to 4 is intermediate risk — further clinical context (such as whether you answered yes to multiple STOP questions combined with male sex, high BMI, or large neck) may reclassify you as high risk. A score of 5 to 8 is high risk, indicating a strong likelihood of moderate-to-severe OSA that warrants formal evaluation.
It is important to understand that STOP-BANG is a screening tool, not a diagnostic test. A high score does not confirm sleep apnea — it means the probability is elevated and a sleep study (polysomnography or home sleep apnea test) is strongly recommended. Conversely, a low score substantially reduces but does not completely eliminate the possibility, particularly in younger, thinner women who may present atypically.
No. A high STOP-BANG score means you have several established risk factors for obstructive sleep apnea and that further evaluation is warranted — it does not constitute a diagnosis. The questionnaire has high sensitivity (93% for moderate-to-severe OSA) but lower specificity (around 43%), which means it deliberately casts a wide net: it catches most true cases but also flags some people who do not ultimately have clinically significant OSA.
Only a formal sleep study — either an in-lab polysomnography (PSG) or an at-home sleep apnea test (HSAT) — can diagnose sleep apnea by measuring your Apnea-Hypopnea Index (AHI), the number of breathing disruptions per hour of sleep. If your score is 5 or higher, or if you are in the intermediate range with additional risk factors, scheduling a conversation with your doctor or a sleep medicine specialist is the recommended next step.
Polysomnography (PSG) is the gold-standard diagnostic test for sleep apnea. During an overnight study at a sleep center, sensors monitor your brain waves (EEG), eye movements (EOG), muscle activity (EMG), heart rhythm (ECG), blood oxygen saturation (pulse oximetry), airflow through the nose and mouth, respiratory effort (chest and abdominal belts), body position, and leg movements. A trained sleep technologist monitors the data in real time throughout the night.
A simpler alternative is the home sleep apnea test (HSAT), a portable device you wear in your own bed that typically measures airflow, blood oxygen, and respiratory effort. HSAT is less comprehensive than PSG but is sufficient to diagnose moderate-to-severe OSA in most uncomplicated adult cases. Both tests report an Apnea-Hypopnea Index (AHI): mild OSA is 5-14 events per hour, moderate is 15-29, and severe is 30 or more. Your doctor will recommend the appropriate test type based on your clinical profile.
Yes — sleep apnea can be treated effectively, and in some cases resolved entirely. CPAP therapy (continuous positive airway pressure) is the first-line treatment for moderate-to-severe OSA. A bedside machine delivers pressurized air through a mask, keeping the airway open during sleep. Modern CPAP devices are quieter and more comfortable than older models, and most patients experience significant symptom improvement within days of consistent use.
Other treatment options include oral appliances (mandibular advancement devices) that reposition the lower jaw to keep the airway open — effective for mild-to-moderate OSA or CPAP-intolerant patients. Weight loss is the most impactful lifestyle modification, as even a 10% reduction in body weight can halve the AHI in overweight patients. Positional therapy (avoiding supine sleep) helps patients whose apnea occurs primarily on their back. Surgical options such as UPPP, maxillomandibular advancement, or hypoglossal nerve stimulation (Inspire) are available for specific anatomical causes or treatment-refractory cases.
The STOP-BANG questionnaire is appropriate for any adult who snores, experiences daytime fatigue, or has been told they stop breathing during sleep. It is particularly valuable for people with known risk factors: obesity (especially BMI over 35), hypertension, age over 50, male sex, or a neck circumference over 40 cm (16 inches). Bed partners of heavy snorers often provide the first clue that a screening is warranted.
Certain populations should be especially proactive about screening: people with treatment-resistant hypertension (OSA is the leading secondary cause), those being evaluated for pre-operative surgical clearance (undiagnosed OSA increases anesthesia risk), commercial truck drivers and pilots (regulatory bodies increasingly require screening), and anyone with unexplained excessive daytime sleepiness despite adequate sleep duration. If you recognize yourself in any of these groups, completing this questionnaire and sharing results with your healthcare provider is a reasonable first step.