STOP-Bang screens adults for obstructive sleep apnea with eight yes-or-no criteria: four on snoring, tiredness, stopped breathing, and blood pressure, and four on BMI, age, neck size, and sex. The total, from 0 to 8, puts the risk at low, intermediate, or high. See what each risk level means, when a 3 or 4 counts as high risk, and when the result leads to a sleep study or an anesthesia alert, then record it with the free template.
STOP-Bang result template
FreeSTOP-BANG SCREEN Screened on: [Date] Patient: [Name or ID] Setting: [Pre-surgery clinic, sleep clinic, primary care, hospital ward, or other] Planned procedure: [Operation, date, and planned anesthesia, or none] Form: [Version your service is licensed to use, language, and who asked the questions] CRITERIA Snoring: [Yes or no; reported by the patient or a bed partner] Tiredness: [Yes or no] Observed stopped breathing: [Yes or no; seen by whom, or no one sees them sleep] High blood pressure: [Yes or no; diagnosed or treated, and today's reading] BMI over 35: [Yes or no; measured height, weight, and BMI] Age over 50: [Yes or no; age] Neck at or over cutoff: [Yes or no; measured size in cm and the cutoff used] Male sex: [Yes or no] RESULT STOP score: [Yes answers to the first four, 0 to 4] Total: [0 to 8] Risk level: [Low, intermediate, or high] Rule applied: [Total alone, or STOP of 2 or more plus male sex, BMI over 35, or a large neck] OTHER FINDINGS Bloods and oxygen: [Serum bicarbonate, resting oxygen saturation] Airway: [Mallampati class, mouth opening, jaw and neck movement] Heart and lung disease: [Heart failure, pulmonary hypertension, lung disease, or none; controlled or not] Sleepiness and driving: [Daytime sleepiness, any score used, and drowsy driving] ACTIONS Sleep testing: [Home sleep apnea test, in-lab study, sleep clinic referral, or none; date booked] Anesthesia alert: [Who was told, when, and the precautions requested] Positional and lifestyle advice: [Side sleeping, head of bed raised, evening alcohol, sedatives, weight] CPAP: [Already uses one and brings it to hospital, or not applicable] Patient told: [What was explained about the result and the next steps] Screen again: [When, or what change would prompt it] Recorded by: [Name, role]
Use it for
The patient answers yes or no on snoring, daytime tiredness, observed pauses in breathing, and high blood pressure, on the licensed form or read aloud from it.
Avoid: Scoring observed apneas as a firm no when the patient sleeps alone. Note that no one sees them sleep: the screen may undercount.
BMI, age, neck size, and sex come from the chart and a tape measure, not from the patient’s estimate.
Avoid: Writing only “neck large.” Record the measured size so the next screen can be compared.
Add the yes answers for a total from 0 to 8, then check whether a total of 3 or 4 moves up to high risk.
Avoid: Calling a 3 or 4 intermediate without checking the rule. A 52-year-old man who snores and is always tired scores 4, and he is high risk.
A high result goes to the anesthesia team before the day of surgery, with what the screen and the exam found.
Avoid: Postponing an elective operation on the score alone. Most patients with suspected apnea can go ahead with precautions.
Outside surgery, a high result, or an intermediate one that fits the story, leads to a sleep study.
Avoid: Adding “sleep apnea” to the problem list from the screen. Until a study confirms it, it’s suspected sleep apnea.
Each one follows the recording template. Use them to judge how much to write.
Pre-surgery clinic, three weeks before an elective total knee replacement, screen done by the clinic nurse
Snoring: yes, loud enough that his wife moved to another room two years ago. Tiredness: yes, most afternoons. Observed stopped breathing: no, though no one sees him sleep now. High blood pressure: yes, on amlodipine and ramipril, 142/88 today. BMI over 35: no, BMI 33.5 at 1.78 m and 106 kg. Age over 50: yes, 58. Neck: yes, 44 cm measured. Male sex: yes.
STOP score 3. Total 6 of 8: high risk on the total alone. The STOP rule also applies: STOP of 3 with male sex and a 44 cm neck.
Bicarbonate 29 mmol/L. Resting oxygen saturation 95% on room air. Mallampati class 3, thick neck, full jaw movement. No heart failure, pulmonary hypertension, or lung disease. Epworth score 9: not very sleepy, which doesn’t lower the apnea risk. Drives only locally, no drowsy driving.
Anesthesia alert sent to the anesthesiologist on his list the same day: suspected moderate to severe sleep apnea, possible difficult mask ventilation; consider spinal anesthesia with a nerve block, opioid-sparing pain relief, and continuous oxygen monitoring on the ward. Home sleep apnea test booked for next week; if apnea is confirmed and CPAP started, he brings the machine to hospital. Surgery date kept: no signs of hypoventilation or uncontrolled heart or lung disease. Advised to sleep on his side with the head raised, and no alcohol or sleeping pills around the operation.
Family practice, visit for tiredness, screen asked and measured by her physician
Snoring: yes, mostly when she has a cold, her partner says. Tiredness: yes, for about 3 months. Observed stopped breathing: no, her partner has never noticed pauses. High blood pressure: no, 118/74. BMI over 35: no, BMI 26. Age over 50: no, 34. Neck: no, 34 cm. Male sex: no.
STOP score 2. Total 2 of 8: low risk. The STOP rule doesn’t apply: STOP is 2, but she isn’t male, her BMI is under 35, and her neck is well under 40 cm.
Sleeps about 6 hours on work nights, grading papers until midnight; wakes refreshed after 8 hours at weekends. Heavy periods for a year. Ferritin low at 9; hemoglobin and thyroid tests normal. PHQ-9 of 4. No nasal blockage between colds. Not dozing at the wheel.
No sleep study: low risk, and the tiredness has likelier causes. Iron started for iron deficiency, and heavy periods to be looked into. Advice on a protected 7 to 8 hours of sleep on work nights. Screen again if the snoring worsens, her partner sees pauses, or her weight or blood pressure rises. Review in 8 weeks with a repeat ferritin.
A 3 or 4 isn’t always intermediate. STOP of 2 or more with male sex, a BMI over 35, or a large neck makes it high risk, and that changes what happens next.
Self-reported weight and collar size tend to run low. Measure the neck and the BMI, and write the numbers down.
A high score means suspected apnea. The sleep study confirms it and sets the severity; record it as suspected until then.
A high-risk screen that never reaches the anesthesia team can’t change the plan for the day of surgery. Send it, and record who you told.
A high score alone isn’t a reason to delay an elective operation. Look for uncontrolled heart or lung disease and low resting oxygen; otherwise go ahead with precautions.
Vero Scribe records the STOP-Bang result in your template from the visit, with the patient’s consent, or from your dictation: each criterion, the total, the rule that set the risk level, and what you did next. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
Each of the eight criteria answered yes scores 1: snoring, tiredness, observed stopped breathing, high blood pressure, a BMI over 35, age over 50, a neck of 40 cm or more, and male sex. Add them for a total from 0 to 8. Then check the STOP rule, which can move a total of 3 or 4 into the high risk band.
0 to 2 is low risk, 3 to 4 intermediate risk, and 5 to 8 high risk of obstructive sleep apnea. The official site puts the risk of moderate to severe apnea, compared with 0 to 2, at about 2.5 times higher at 3, 3 times at 4, 5 times at 5, 6 times at 6, and 7 times at 7 or 8.
When 2 or more of the four STOP criteria are yes, and the patient is also male, has a BMI over 35, or has a neck of 40 cm or more. That combination counts as high risk. Without it, a 3 or 4 stays intermediate, and the history decides whether to test.
It’s sensitive but not very specific. In the first surgical study, a total of 3 or more found 93% of patients with moderate apnea and all of those with severe apnea, but many who scored 3 or more didn’t have it. Higher totals and the STOP rule pick out the people most likely to have it, and a low score makes moderate to severe apnea unlikely.
The anesthesia team is told, so they can plan for a difficult airway, use regional anesthesia and fewer opioids where possible, and monitor oxygen after the operation. Most patients go ahead as planned with these precautions. Uncontrolled heart or lung disease, signs of hypoventilation, or low resting oxygen need assessing first. A sleep study follows, before or after surgery depending on timing.
STOP-Bang estimates how likely obstructive sleep apnea is from symptoms, blood pressure, and body measures. The Epworth measures how sleepy someone is in the daytime, whatever the cause. Many people with significant apnea aren’t very sleepy, so a normal Epworth doesn’t cancel out a high STOP-Bang result. Clinics often use both.
With a flexible tape around the neck at the Adam’s apple, the patient upright. The official site counts 40 cm, or a 16-inch shirt collar, or more as yes for everyone. Some printed versions use 43 cm, a 17-inch collar, for men and 41 cm for women. Use the cutoffs of the version you’re licensed for.
Any trained member of the care team. Pre-surgery nurses often run it, and patients can answer the four STOP questions themselves on paper or online. The Bang criteria need a measured height, weight, and neck. It takes a minute or two.
It belongs to University Health Network, and using it needs permission. Academic research projects and publications request an academic license online. Routine patient intake or screening, clinical trials, and industry-sponsored research need a license arranged with the owner, through the contact on the official STOP-Bang site. The recording template on this page is free to copy or download.
Eight everyday situations rated for the chance of dozing: daytime sleepiness scored 0 to 24, with above 10 excessive.
The full pre-surgery assessment, with airway, risk scores, and the anesthesia plan.
For the study that follows a high score: AHI, oxygen levels, and treatment.
Sleep clinic visits, study results, and CPAP follow-up.
Every tool, by area, with what its scores mean.
Vero records scores, findings, and plans in the templates you choose, so you review instead of type.
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