The STOP-Bang questionnaire is one of the most widely used tools in sleep medicine to assess the risk of obstructive sleep apnea (OSA). Simple and quick, it covers eight yes/no questions that give clinicians a strong indication of whether further testing is needed.
But for many people, scoring themselves online or through a screening tool can lead to confusion. What does a score of 3 versus 5 mean? And what are the best next steps based on your result?
In this post, we break down the meaning behind each part of the STOP-Bang tool, what your total score indicates, and how to move forward confidently if your numbers suggest possible sleep apnea.
What Is the STOP-Bang Questionnaire?
STOP-Bang is an acronym for:
- Snoring
- Tiredness during daytime
- Observed apneas
- Pressure (high blood pressure)
- Body mass index (BMI)
- Age
- Neck circumference
- Gender
Each factor reflects a common risk element for OSA. The tool is widely recommended in both primary care and sleep clinic settings because it is easy to administer and highly predictive of moderate to severe OSA.
How Scoring Works
Each “yes” answer earns 1 point, with a maximum score of 8. Generally:
- 0–2: Low risk
- 3–4: Intermediate risk
- 5–8: High risk
However, this breakdown isn’t always so black-and-white. Context matters. For instance, someone with a score of 3 but significant symptoms may still warrant a home sleep apnea test.
STOP Section: Symptoms You Feel and Others Notice
The first four questions assess common signs and symptoms:
- Snoring: Loud, habitual snoring is a key symptom of OSA. It suggests airway obstruction during sleep.
- Tiredness: Daytime fatigue or frequent naps signal non-restorative sleep, even if you don’t recall waking at night.
- Observed Apneas: Has someone witnessed you stop breathing during sleep? This is a strong indicator that you may need further testing.
- Pressure (Blood Pressure): High blood pressure is both a symptom and a risk factor for untreated OSA, often due to repetitive drops in oxygen overnight.
If you score 2 or more in this section, you already meet the threshold for “positive” STOP.
BANG Section: Measurable Physical Risk Factors
The next four items assess structural or demographic risks:
- BMI >35 kg/m²: Higher body mass index increases the chance of soft tissue pressing against the airway during sleep.
- Age ≥50: Risk increases with age due to loss of upper airway muscle tone and other physiologic changes.
- Neck circumference: A larger neck (≥17 inches in men, ≥16 inches in women) is strongly correlated with upper airway narrowing.
- Gender: Males are statistically more likely to develop OSA, though OSA in women is often underdiagnosed.
If you scored high in this section, it suggests anatomical or systemic predisposition.
What Your Total STOP-Bang Score Means
Low Risk (0–2)
While a low score is reassuring, it doesn’t always mean you’re in the clear. Some patients—especially young women or children—may present with subtle symptoms not fully captured by this tool.
What to do: Keep monitoring symptoms. If fatigue, snoring, or morning headaches develop, retake the questionnaire or speak to your provider.
Intermediate Risk (3–4)
This range represents a gray area. Many individuals in this category may still have clinically significant sleep apnea, especially if multiple STOP symptoms are present.
What to do: You may benefit from a facial scan to assess airway structure or a home sleep apnea test for data collection over a few nights.
High Risk (5–8)
At this level, the likelihood of moderate to severe OSA is high. Many patients in this category will show an apnea-hypopnea index (AHI) above 15 events/hour during testing.
What to do: Prioritize a diagnostic sleep test, which may include polysomnography in a lab or home-based equipment with sensors on your finger and chest.
Limitations to Be Aware Of
Although the STOP-Bang score is useful, it’s not foolproof. The tool has some blind spots:
- It doesn’t capture insomnia symptoms that may co-exist with apnea
- Mild OSA may not be detected at all, especially in otherwise healthy individuals
- Women and children tend to present with symptoms (fatigue, mood changes, etc.) that aren’t fully reflected in the questionnaire
That’s why it’s important to combine the score with clinical judgment and other tools like facial scans, overnight oximetry, or wearable data.
Pairing STOP-Bang with Other Tools
Some clinics now combine STOP-Bang scores with AI-based facial scanning, which reads facial landmarks linked to airway anatomy. When used together, these tools offer higher accuracy than either alone.
A low STOP-Bang score doesn’t guarantee zero risk—especially if your face shape or scan indicates narrowing around the jaw or midface.
What If My Score Is High, But I Feel Fine?
Many people with sleep apnea feel “normal” because they’ve adapted to low-quality sleep. Others may only experience subtle issues like brain fog, poor concentration, or unexplained weight gain.
The risk isn’t just poor sleep—it’s long-term consequences like:
- High blood pressure
- Heart rhythm issues
- Blood sugar spikes
- Cognitive decline
If your STOP-Bang score says high risk, take it seriously. It’s better to catch a problem early than wait for symptoms to worsen.
Next Steps Based on Your Score
Here’s a breakdown of what action to consider based on where you land:
| Score | Action |
| 0–2 | No action unless symptoms worsen |
| 3–4 | Consider a home sleep test or facial scan |
| 5–8 | Schedule diagnostic testing with a provider |
Bottom Line
The STOP-Bang tool is a helpful first step in recognizing your risk for sleep apnea. But it’s just the beginning. Think of it as a guide—not a diagnosis.
Combining it with modern screening tech, awareness of subtle symptoms, and follow-up testing ensures that you don’t let sleep apnea fly under the radar.
Your score is more than a number—it’s a signal. Use it to ask questions, gather data, and get the sleep you deserve.
