Obstructive Sleep Apnea (OSA) screening
Total Score
Low risk of Obstructive Sleep Apnea.
Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.
Yasal Uyarı: Bu platformdaki klinik skorlamalar ve algoritmalar yalnızca sağlık profesyonellerini bilgilendirme amaçlıdır. Herhangi bir kesin tıbbi teşhis, tedavi veya klinik karar yerine geçemez. Nihai karar ve sorumluluk hastayı yatak başında değerlendiren hekime aittir.
The STOP-BANG questionnaire is a highly sensitive, universally utilized screening tool to identify patients at risk for Obstructive Sleep Apnea (OSA). It is particularly valuable in preoperative assessment clinics to alert anesthesiologists to the potential for difficult airways and postoperative respiratory depression.
A score of ≥3 has a high sensitivity for detecting moderate-to-severe OSA, but a high score (e.g., 5-8) significantly increases the specificity. If a patient scheduled for elective surgery scores high, consider a formal sleep study (polysomnography) or empiric CPAP management perioperatively.
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.
Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.
Apply STOP-BANG to adults in pre-operative clinics, sleep medicine referrals, and primary care screening to identify those at risk for moderate-to-severe OSA. A score of 0–2 indicates low OSA risk; 3–4 intermediate; 5–8 high. In the pre-operative setting, a high-risk STOP-BANG score (≥ 5) should prompt anaesthetic planning for potential difficult airway, post-operative CPAP, and extended recovery monitoring. For definitive diagnosis, refer high-risk or symptomatic patients for polysomnography (in-lab sleep study) or a validated home sleep apnea test (HSAT).
Adding gender, BMI, and neck circumference — the 'BANG' components — substantially improves specificity compared to the original 4-item STOP questionnaire alone. In high-surgical-risk patients (bariatric surgery, cardiac surgery, upper airway procedures), even a STOP-BANG score of 3–4 may justify pre-operative sleep study. Untreated OSA is independently associated with increased risk of atrial fibrillation, resistant hypertension, post-operative hypoxaemia, unplanned ICU admission, and sudden cardiac death — early identification has real clinical consequence.
STOP-BANG has high sensitivity but relatively low specificity — a high score does not confirm OSA, and polysomnography is required for diagnosis. The 'observed apnea' criterion relies on a bed partner's report and may be absent in patients who sleep alone, underestimating true risk in that population. BMI > 35 and neck circumference > 40 cm are the most objective criteria; ensure measurements are current and accurate, as weight changes significantly alter OSA risk. STOP-BANG was validated primarily in surgical populations; its performance may differ in general community screenings.