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STOP-BANG
Screen for obstructive sleep apnea risk. Important pre-operatively and in resistant hypertension, atrial fibrillation, or metabolic syndrome.
Indication
- Screen for obstructive sleep apnea risk. Important pre-operatively and in resistant hypertension, atrial fibrillation, or metabolic syndrome.
Criteria
- id: s; label: S — Snore loudly; type: yesno; points: 1
- id: t; label: T — Tired/fatigued/sleepy in daytime; type: yesno; points: 1
- id: o; label: O — Observed to stop breathing in sleep; type: yesno; points: 1
- id: p; label: P — High blood pressure (or treated); type: yesno; points: 1
- id: b; label: B — BMI >35; type: yesno; points: 1
- id: a; label: A — Age >50 years; type: yesno; points: 1
- id: n; label: N — Neck circumference >40 cm; type: yesno; points: 1
- id: g; label: G — Male gender; type: yesno; points: 1
Interpretation
- function(score) { if (score <= 2) return { risk: score + '/8', tier: 'Low Risk', action: 'Low risk for obstructive sleep apnea.', color: 'green' }; if (score <= 4) return { risk: score + '/8', tier: 'Intermediate Risk', action: 'Consider a sleep study, especially if symptomatic.', color: 'yellow' }; return { risk: score + '/8', tier: 'High Risk', action: 'Sleep study recommended. Pre-op precautions: post-op continuous monitoring, avoid deep sedation, prefer regional anesthesia, CPAP if already diagnosed.', color: 'red' }; }
Clinical pearls
- High sensitivity (>90%) for moderate-severe OSA makes STOP-BANG useful as a rule-out tool
- Specificity is lower (~50%) — many positive screens will not have OSA
- OSA is present in 70–80% of patients with treatment-resistant hypertension
- Undiagnosed OSA significantly increases perioperative risk
Source and review
- Chung F et al. Anesthesiology 2008. Last reviewed: 2025-01-01