Last reviewed May 6, 2026 by NPBoardSlay Medical Review Board

STOP-BANG

Obstructive Sleep Apnea Screen

≥3 yes → likely OSA — refer for sleep study.

What this mnemonic does is collapse an OSA screen into eight yes-or-no questions any NP can run during a wellness visit. STOP-BANG — Snoring loudly, Tired during the day, Observed apneas, Pressure (hypertension), BMI over 35, Age over 50, Neck circumference over 17 inches in men or 16 in women, Gender male — yields 0-8. Three or more is intermediate-to-high risk and warrants referral for sleep study. Five or more is high probability of moderate-to-severe OSA. AANP exam vignettes use STOP-BANG to test pre-operative risk stratification and screening in the obese hypertensive patient with daytime fatigue. Refer for polysomnography; CPAP is the answer once confirmed.

S
Snoring
Loud enough to be heard through a door?
T
Tired
Daytime fatigue or sleepiness?
O
Observed apnea
Partner witnesses pauses in breathing?
P
Pressure
High blood pressure (or on treatment)?
B
BMI
>35?
A
Age
>50?
N
Neck circumference
>17" (43 cm) men / >16" (41 cm) women?
G
Gender
Male?

Clinical Context

Validated OSA screening tool used in primary care and preoperatively. 3+ positive = intermediate risk; 5+ = high risk and definitely warrants polysomnography. Diagnosis requires a sleep study (home or lab).

AANP tests OSA as a contributor to resistant hypertension, cardiovascular risk, and daytime fatigue. First-line treatment is CPAP, plus weight loss and positional therapy. Untreated OSA elevates perioperative risk — identify before any elective surgery.