STOP-BANG Questionnaire

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MM slash DD slash YYYY
MM slash DD slash YYYY
Do you Snore Loudly (loud enough to be heard through closed doors or your bed-partner elbows you for snoring at night)?
Do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleep during driving or talking to someone)?
Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep?
Do you have or are currently being treated for High Blood Pressure?
Body Mass Index?
Is your Body Mass Index more than 35 kg/m2?
Click button below to calculate your BMI
Age over 50?
Are you older than 50 years of age?
Neck size large?
(measured around Adams apple)
For male, is your shirt collar 17 inches/43cm or larger?
For female, is your shirt collar 16 inches/41cm or larger?
Gender = Male?
Scoring Criteria for general population:
Low risk of OSA: Yes to 0-2 questions
Intermediate risk of OSA: Yes to 3-4 questions
High Risk of OSA: Yes to 5-8 questions
Or Yes to 2 or more of 4 STOP questions + male gender
Or Yes to 2 or more of 4 STOP questions + BMI > 35kg/m2
Or Yes to 2 or more of 4 STOP questions + neck circumference (17”/43cm in male, 16”/41cm in female)

Proprietary to University Health Network.
Modified from: Chung F et al. Anesthesiology 2008, 108:812-821; Chung F et al. Br J Anaesth 2012, 108:768-775; Chung F et al. J Clin Sleep Med 2014, 10:951-8.
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