Sleep Tools
STOP-BANG Questionnaire
Answer 8 yes/no questions to assess your risk for obstructive sleep apnea using this clinically validated screening tool.
Answer each question
Be as honest as possible. There are no wrong answers.
Do you snore loudly, louder than talking or loud enough to be heard through closed doors?
Do you often feel tired, fatigued, or sleepy during the daytime?
Has anyone observed you stop breathing, choking, or gasping during your sleep?
Do you have or are you being treated for high blood pressure?
Is your BMI greater than 35?
Are you older than 50?
Is your neck circumference greater than 40 cm (15.7 inches)?
Were you assigned male at birth?
Frequently Asked Questions
What STOP-BANG measures and how to use the results.
What is Obstructive Sleep Apnea?
Obstructive sleep apnea (OSA) is a chronic condition in which the muscles at the back of the throat relax during sleep, causing the airway to collapse partially or completely. Breathing stops, sometimes dozens or hundreds of times per night, and the brain briefly wakes you to reopen the airway. Most people have no memory of these awakenings, but the cumulative effect is severely fragmented sleep.
OSA affects an estimated 1 billion people worldwide, including approximately 30 million Americans. Despite its prevalence, roughly 80% of people with moderate-to-severe OSA remain undiagnosed. Left untreated, OSA is associated with hypertension, heart disease, type 2 diabetes, stroke, cognitive impairment, and depression.
Key Fact
Studies show untreated OSA raises cardiovascular disease risk by 2–3x.
The 8 STOP-BANG Risk Factors Explained
Each letter in STOP-BANG represents a clinically validated risk factor for obstructive sleep apnea.
Snoring
Snoring is caused by vibration of relaxed throat tissue as air passes through a narrowed airway. Loudness and frequency generally correlate with OSA severity, though not everyone who snores has OSA.
Tiredness
Excessive daytime sleepiness (EDS) results from the fragmented, non-restorative sleep that OSA causes. EDS affects an estimated 60–70% of OSA patients and impairs work performance, driving safety, and quality of life.
Observed Apneas
A bed partner witnessing you stop breathing, choke, or gasp is the most specific indicator of OSA. It represents direct evidence of airway collapse and is a strong predictor of moderate-to-severe disease.
Blood Pressure
OSA and hypertension are bidirectional, each worsens the other. Repeated oxygen desaturations during apnea events activate the sympathetic nervous system, raising blood pressure. Treating OSA can meaningfully lower BP.
BMI >35
Excess fatty tissue around the neck, tongue, and pharyngeal walls narrows the upper airway. Research shows that even a 10% reduction in body weight can reduce the Apnea-Hypopnea Index (AHI) by approximately 26%.
Age >50
Upper airway muscle tone decreases with age, making airway collapse during sleep more likely. OSA prevalence rises sharply after age 50, particularly in men.
Neck >40 cm
Neck circumference is one of the strongest anatomical predictors of OSA. A collar size above 40 cm (roughly 16 inches) reflects the soft tissue mass surrounding the airway and is independently associated with OSA risk.
Gender
Males have a 2–3x higher OSA risk than females, partly due to differences in airway anatomy, fat distribution, and hormones. Women's risk increases significantly after menopause as protective hormonal effects decline.
STOP-BANG vs Other Screening Tools
Several tools exist for OSA screening and diagnosis. Here is how they compare and when to use each one.
| Tool | Type | Best For | Sensitivity | Where to Start |
|---|---|---|---|---|
| STOP-BANG | Risk questionnaire | Pre-surgical + primary screening | 87–93% for severe OSA | Start here if you haven't been screened |
| Epworth Sleepiness Scale (ESS) | Symptom scale | Measuring daytime sleepiness | N/A (complements STOP-BANG) | Use alongside STOP-BANG |
| AHI Calculator | Index calculator | After a sleep study | Definitive | After you have sleep study results |
| Home Sleep Test (HST) | Diagnostic | At-home OSA diagnosis | 85–90% | After high STOP-BANG score |
Who Should Use the STOP-BANG Questionnaire?
STOP-BANG was originally developed for anesthesiologists screening patients before surgery, and has since become a standard tool in primary care and self-assessment.
Pre-Surgical Patients
STOP-BANG was originally developed to help anesthesiologists identify patients at elevated risk for perioperative complications from undiagnosed OSA. It is now standard in many pre-operative protocols.
Primary Care Screening
Family physicians use STOP-BANG to quickly stratify patients and decide who needs a referral for a formal sleep study. A score of 3 or higher typically warrants further evaluation.
Self-Assessment
Anyone concerned about snoring, persistent fatigue, or cardiovascular risk can use STOP-BANG to understand their risk level and decide whether to pursue diagnostic testing.
If you scored 3 or higher, an at-home sleep test is a simple next step. Explore sleep care at Dumbo Health →
Key Takeaways
- STOP-BANG has 87–93% sensitivity for detecting moderate-to-severe OSA.
- A score of 5–8 puts you in the high-risk category for OSA.
- 80% of people with moderate-to-severe OSA are undiagnosed.
- OSA is linked to hypertension, heart disease, type 2 diabetes, and stroke.
- An at-home sleep test is the standard first step after a high STOP-BANG score.
Clinical References
- Chung F, et al. "STOP Questionnaire: A Tool to Screen Patients for Obstructive Sleep Apnea." Anesthesiology. 2008.
- Chung F, et al. "High STOP-BANG score indicates a high probability of obstructive sleep apnoea." British Journal of Anaesthesia. 2012.
- Benjafield AV, et al. "Estimation of the global prevalence and burden of obstructive sleep apnoea." The Lancet Respiratory Medicine. 2019.
- Peppard PE, et al. "Increased Prevalence of Sleep-Disordered Breathing in Adults." American Journal of Epidemiology. 2013.