What Is the STOP-BANG Questionnaire?

The STOP-BANG questionnaire is a validated screening tool for obstructive sleep apnea (OSA). It was developed by Dr. Frances Chung and colleagues at the University Health Network in Toronto and published in 2008 in Anesthesiology. The original purpose was to give anesthesiologists a fast, reliable way to identify surgical patients at risk for OSA before they go under general anesthesia, because undiagnosed sleep apnea significantly increases the risk of airway complications during and after surgery.

Since then, the STOP-BANG has become one of the most widely used OSA screening tools in the world. It has been validated across dozens of studies in surgical, sleep clinic, and general population settings. Its strength is simplicity: eight yes/no questions that take under two minutes to complete.

It is not a diagnosis. No questionnaire can replace a polysomnogram or home sleep test. But as a triage tool, the STOP-BANG reliably separates people who should be evaluated for sleep apnea from people who can safely wait. Take the STOP-BANG Screener now to see where you stand.

What STOP-BANG Stands For

Each letter in STOP-BANG corresponds to one question. The first four (STOP) are subjective symptoms. The last four (BANG) are measurable physical characteristics.

S: Snoring

Do you snore loudly, loud enough to be heard through closed doors? Habitual loud snoring is one of the most common presentations of obstructive sleep apnea. The sound is produced by partial airway collapse during sleep. Not everyone who snores has sleep apnea, but nearly everyone with OSA snores. For more context, see our guide on why snoring matters.

T: Tired

Do you often feel tired, fatigued, or sleepy during the daytime? Repeated airway obstructions fragment your sleep architecture, preventing you from reaching or sustaining the deeper stages of sleep that restore energy. The result is daytime fatigue that does not improve with more hours in bed. If sleepiness is your primary concern, the Epworth Sleepiness Scale quantifies it in more detail.

O: Observed

Has anyone observed you stop breathing or choking/gasping during your sleep? Witnessed apneas are the single strongest clinical indicator of OSA. Most people with sleep apnea are unaware of their breathing pauses. A bed partner's observations are often the first clue. If you sleep alone, this question may be difficult to answer, which is a known limitation of the tool.

P: Pressure

Are you being treated for high blood pressure? The relationship between OSA and hypertension is bidirectional. Untreated sleep apnea contributes to sustained elevated blood pressure through repeated sympathetic nervous system activation during apnea events. Conversely, hypertension is an independent risk factor for having OSA. The American Heart Association recognizes OSA as a secondary cause of resistant hypertension.

B: BMI

Is your body mass index (BMI) greater than 35? Excess adipose tissue around the upper airway narrows the pharyngeal space and increases the mechanical load on the airway during sleep. A BMI over 35 (Class II obesity) substantially increases the likelihood of OSA. The STOP-BANG tool on CPAP Clarity includes a built-in BMI calculator so you do not need to compute it separately.

A: Age

Are you over 50 years old? OSA prevalence increases with age. The pharyngeal muscles that keep the airway open during sleep lose tone over time. The Wisconsin Sleep Cohort Study (Young et al., 1993, New England Journal of Medicine) found that OSA prevalence increases progressively from age 30 through 60.

N: Neck

Is your neck circumference greater than 16 inches (40 cm)? A larger neck correlates with more soft tissue around the airway, increasing the likelihood of collapse during sleep. This is one of the strongest anthropometric predictors of OSA and is independent of overall BMI.

G: Gender

Are you male? Males are approximately two to three times more likely to have OSA than females in most studied populations (Young et al., 1993). This disparity narrows after menopause, suggesting hormonal factors play a protective role. The STOP-BANG's inclusion of gender as a risk factor reflects this well-established epidemiological finding, though it means the tool may underestimate risk in postmenopausal women. For more on this topic, see our article on sleep apnea in women.

How the STOP-BANG Is Scored

Scoring is straightforward: count the number of "yes" answers out of eight.

Score	Risk Level	Interpretation
0-2	Low risk	OSA is less likely, though not ruled out
3-4	Intermediate risk	OSA is possible; clinical evaluation recommended
5-8	High risk	OSA is probable; a sleep study is strongly recommended

There are no weighted questions. Every "yes" counts equally. This design choice prioritizes simplicity over nuance: the tool trades some precision for universal ease of use.

How Accurate Is the STOP-BANG?

The STOP-BANG has been extensively validated. Key findings from the literature:

For moderate to severe OSA (AHI >= 15):

Sensitivity: approximately 90% in the original validation (Chung et al., 2008, Anesthesiology)
Subsequent meta-analyses report sensitivity ranging from 88% to 97% across surgical, sleep clinic, and general populations (Nagappa et al., 2015, British Journal of Anaesthesia)

For severe OSA (AHI >= 30):

Sensitivity exceeds 95% in most studies, meaning the STOP-BANG very rarely misses severe cases

Specificity:

Approximately 37-49% for moderate to severe OSA in the original study
This means a meaningful number of people who score high risk do not actually have OSA (false positives)

In practical terms: the STOP-BANG is designed to cast a wide net. It catches nearly all true cases at the cost of flagging some people who turn out to be fine. For a screening tool, this is the right trade-off. Missing true OSA is far more dangerous than ordering an unnecessary sleep study.

The tool performs best in populations with higher baseline OSA prevalence (surgical patients, sleep clinic referrals). In lower-prevalence general populations, the false positive rate is higher but sensitivity remains strong.

STOP-BANG vs. Berlin vs. Epworth

Three screening tools come up most often in sleep apnea evaluation. Each one measures something different.

Feature	STOP-BANG	Berlin Questionnaire	Epworth Sleepiness Scale
Questions	8 yes/no items	10 across 3 categories	8 situation-based ratings
Focus	Binary risk factors	Symptom frequency patterns	Daytime sleepiness only
Scoring	Count-based (5+ = high risk)	Category-based (2+ positive = high risk)	Sum (0-24, >10 = excessive sleepiness)
Sensitivity	~90% (moderate-severe OSA)	~86% (moderate-severe OSA)	Not designed to detect OSA directly
Best for	Quick screening in any setting	Primary care screening with frequency data	Quantifying subjective sleepiness
Developed	Chung et al., 2008	Netzer et al., 1999	Johns, 1991
Take it	STOP-BANG	Berlin Questionnaire	Epworth Scale

The STOP-BANG is the fastest of the three and has the highest sensitivity for moderate to severe OSA. The Berlin Questionnaire captures symptom frequency (how often you snore, how often you feel tired) which the STOP-BANG does not. The Epworth Sleepiness Scale measures daytime sleepiness specifically and is not an OSA screener.

Using more than one tool gives a clearer picture. If STOP-BANG, Berlin, and Epworth all point in the same direction, the signal is strong. If results are mixed, that information is still valuable for your doctor.

What to Do After Taking the STOP-BANG

If Your Score Is 5-8 (High Risk)

A high-risk STOP-BANG score is a strong signal. The next step is to talk to your doctor about a sleep study. In most cases, that means a home sleep test: a single-night recording done in your own bed that measures airflow, respiratory effort, and oxygen saturation. Results typically come back within a week. Our diagnosis process guide covers what to expect from start to finish.

Consider also taking the Berlin Questionnaire and Epworth Scale before your appointment. Walking in with results from all three screeners demonstrates that you have done your homework and gives your provider a comprehensive starting point.

If Your Score Is 3-4 (Intermediate Risk)

An intermediate score means you have some risk factors but the picture is not conclusive. If you have specific symptoms that concern you (loud snoring, witnessed breathing pauses, waking up gasping, persistent morning headaches), mention them to your doctor even if your overall score is moderate. Our guide on sleep apnea symptoms can help you identify what to watch for.

If Your Score Is 0-2 (Low Risk)

A low-risk score is reassuring but not a guarantee. The STOP-BANG's specificity limitations mean it can miss some cases, particularly in women, younger patients, and people with atypical presentations. If you have concerning symptoms, a low STOP-BANG score should not stop you from pursuing evaluation.

If You Are Already Diagnosed and on CPAP

If you are already on therapy, screening tools are behind you. Your focus now is optimizing treatment. Import your CPAP data into CPAP Clarity to track your AHI, leak rates, pressure patterns, and usage over time. Everything runs in your browser. Your health data never leaves your device.

Limitations of the STOP-BANG

No screening tool is perfect. The STOP-BANG has specific known limitations:

Gender bias. The inclusion of male gender as a scored item means women start with one fewer risk point. Postmenopausal women and women with polycystic ovary syndrome (PCOS) have elevated OSA risk that the tool may not adequately capture.
Solo sleepers. The "Observed" question requires a witness. People who sleep alone cannot answer it reliably, which may lower their score by one point.
Low specificity. The tool flags many people who do not have OSA. A high score is a reason to get tested, not a reason to assume you have the condition.
Not sensitive to central sleep apnea. The STOP-BANG was designed and validated for obstructive sleep apnea. It does not screen for central sleep apnea or treatment-emergent central apnea. If central events are a concern, see our guide on central vs. obstructive apnea.

Take the STOP-BANG Screener

Ready to check your risk? The STOP-BANG Screener on CPAP Clarity takes under two minutes. Your answers are scored instantly in your browser. Nothing is stored, nothing is sent anywhere.

For the most complete picture, take all three screeners:

STOP-BANG Screener for a quick overall risk check
Berlin Questionnaire for frequency-based risk assessment
Epworth Sleepiness Scale for daytime sleepiness severity

Then bring the results to your next appointment, or use them to start the conversation about a sleep study.

This content is for educational purposes and does not constitute medical advice. The STOP-BANG questionnaire is a screening tool, not a diagnostic instrument. Consult your physician for diagnosis and treatment decisions.

STOP-BANG Questionnaire: Sleep Apnea Risk Screening