Instructions
STOP-BANG is a validated 8-item yes/no questionnaire for OSA screening. Each "Yes" = 1 point (maximum 8).
- S — Snoring: Do you snore loudly (louder than talking or loud enough to be heard through closed doors)?
- T — Tired: Do you often feel tired, fatigued, or sleepy during the daytime?
- O — Observed: Has anyone observed you stop breathing during your sleep?
- P — Pressure: Do you have or are you being treated for high blood pressure?
- B — BMI >35 kg/m²
- A — Age >50 years
- N — Neck circumference >40 cm
- G — Gender: Male
Score interpretation:
- 0–2: Low risk for moderate-severe OSA
- 3–4: Intermediate risk
- 5–8: High risk for moderate-severe OSA (sensitivity >90% for AHI ≥15)
All computation runs in your browser; no values are stored or transmitted.
When to Use
Appropriate population
- CKD/ESRD patients — OSA is present in up to 50–80% of dialysis patients and contributes to fluid overload, resistant hypertension, nocturnal hypoxemia, and cardiovascular events
- Pre-anesthesia screening
- Hypertension evaluation workup
- Any patient with daytime somnolence, witnessed apneas, or unexplained polycythemia
Pearls & Pitfalls
Key pearls
- STOP-BANG has high sensitivity but lower specificity — positive score requires polysomnography (PSG) for confirmation
- In CKD/HD patients, OSA contributes to non-dipping BP pattern and residual kidney function decline
- Treat confirmed OSA with CPAP: improves BP, sleep quality, and may slow CKD progression
- Score of ≥5 in pre-op: anesthesia team should prepare for difficult airway and post-op monitoring
- Neck circumference >40 cm may be modified by obesity or local edema in dialysis patients
Why Use It
OSA is dramatically under-diagnosed in CKD and dialysis populations. Identifying and treating OSA can improve BP control, reduce cardiovascular events, and improve dialysis adequacy.
Interactive Tool
STOP-BANG Questionnaire
Check each item that applies. The score and risk category update automatically.
Check all that apply (each = 1 point)
⚕ STOP-BANG is a screening tool, not a diagnostic test. Diagnosis of OSA requires polysomnography or home sleep apnea testing. For educational reference only. Reference: Chung F et al., Anesthesiology 2008.
Next Steps
- Score ≥3: Refer for overnight polysomnography (PSG) or home sleep apnea test (HSAT)
- Confirmed OSA: Initiate CPAP; educate about positional therapy, weight loss
- Resistant hypertension workup: Include OSA assessment with STOP-BANG
Evidence & References
References
- Chung F, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108(5):812–821.
- Kapur VK, et al. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea. J Clin Sleep Med. 2017;13(3):479–504.
- Elias RM, et al. Obstructive sleep apnea in patients with CKD. Clin J Am Soc Nephrol. 2012;7(8):1279–1286.
Important: STOP-BANG is a screening tool and does not diagnose obstructive sleep apnea. Definitive diagnosis requires polysomnography (PSG) or a validated home sleep apnea test (HSAT) performed and interpreted by a qualified clinician. This calculator is for educational reference only and does not replace individualized clinical assessment.
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