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    Licensed instrument

    STOP-Bang: scoring, cutoffs & interpretation

    Licensed eight-item OSA risk screen. Information only - not available to complete here.

    Use these insteadESSISIPSQI

    02 - The clinician's brief

    Last reviewed: · Reviewed by Lotte Kjær Svalberg

    01 - Scoring & cutoffs

    How scoring works.

    STOP-Bang has eight yes/no items, one for each letter of the acronym: loud Snoring, daytime Tiredness, Observed pauses in breathing or choking during sleep, high blood Pressure (diagnosed or treated), Body mass index above 35 kg/m2, Age over 50, Neck circumference above 40 cm (the updated form uses 43 cm for men and 41 cm for women), and male Gender. Each "yes" scores one point, giving a total of 0 to 8.

    A total of 0-2 indicates low risk of obstructive sleep apnoea, 3-4 intermediate risk and 5-8 high risk. Because many people score 3 or 4, the developers added a refinement for the intermediate band: a score of 2 or more on the four STOP symptom items plus male sex, plus a BMI above 35, or plus a large neck circumference also indicates high risk. The STOP-Bang is a triage tool that estimates the probability of OSA; the diagnosis itself requires polysomnography or home sleep testing.

    Score
    Severity
    Interpretation
    0–2
    Low risk
    Low probability of obstructive sleep apnoea. Reassess if symptoms change.
    3–4
    Intermediate risk
    Intermediate probability of OSA. Reclassify as high risk if the STOP score is 2 or more plus male sex, BMI above 35 or a large neck circumference; otherwise consider sleep testing based on clinical context.
    5–8
    High risk
    High probability of moderate-to-severe OSA. Refer for polysomnography or home sleep apnoea testing.

    02 - Licensing, explained

    How licensing works.

    The STOP-Bang questionnaire is proprietary to University Health Network (UHN), Toronto, and the official site (stopbang.ca) asks users to complete UHN's express-licence forms to obtain permission to use it. UHN describes the tool as free of charge for non-profit use, with an annual fee for corporate health partners and a per-administration fee for industry use such as clinical trials. Because an interactive online version is an electronic reproduction that requires UHN's permission, this page explains the STOP-Bang rather than hosting it. Clinicians can view the official questionnaire and its translations at stopbang.ca. Aisel does not currently host a free interactive alternative for sleep-apnoea screening; the ESS (also licensed) covers daytime sleepiness and the ISI and PSQI cover insomnia and sleep quality.

    References

    Source literature.

    1. [1]Chung F, Yegneswaran B, Liao P, et al. STOP Questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108(5):812-821 (2008)
    2. [2]Chung F, Subramanyam R, Liao P, Sasaki E, Shapiro C, Sun Y High STOP-Bang score indicates a high probability of obstructive sleep apnoea. British Journal of Anaesthesia. 2012;108(5):768-775 (2012)
    3. [3]Chung F, Abdullah HR, Liao P STOP-Bang Questionnaire: a practical approach to screen for obstructive sleep apnea. Chest. 2016;149(3):631-638 (2016)

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