# STOP-Bang score

> STOP-Bang is an eight-item screening questionnaire for obstructive sleep apnoea. Each item scores one point — snoring, tiredness, observed apnoeas, high blood pressure, BMI over 35, age over 50, neck circumference over 40cm, and male sex. A score of 5 to 8 indicates high risk of moderate-to-severe OSA.

*Source: https://getpathways.ai/glossary/stop-bang-score*

Also known as: STOP-Bang, STOP-BANG questionnaire

- **Items**: 8 — Snoring, Tiredness, Observed apnoea, Pressure, BMI, Age, Neck, Gender
- **Score range**: 0–8
- **Low risk**: 0–2
- **Intermediate risk**: 3–4
- **High risk**: 5–8
- **Screens for**: Obstructive sleep apnoea (OSA)

## Why it matters before surgery

Undiagnosed obstructive sleep apnoea changes perioperative management. Patients
with significant OSA are more sensitive to sedatives and opioids, are at higher
risk of airway obstruction and desaturation after anaesthesia, and may need
altered post-operative monitoring or a different location of care.

The clinical problem is that most OSA in a surgical population is undiagnosed at
the time of booking. The patient does not report a condition they do not know
they have, so unless the eight questions are actually asked, the risk stays
invisible until the recovery room.

## The eight items

| Item | Scores one point when |
| --- | --- |
| **S**noring | Loud enough to be heard through a closed door |
| **T**iredness | Daytime tiredness, fatigue or sleepiness |
| **O**bserved | Someone has observed the patient stop breathing in their sleep |
| **P**ressure | Treated or untreated high blood pressure |
| **B**MI | Over 35 kg/m² |
| **A**ge | Over 50 |
| **N**eck | Circumference over 40 cm |
| **G**ender | Male |

## How Pathways uses it

The Socrates Pre-Op interview covers the STOP-Bang items as part of its systems
review and social/risk-factor domains, so the score is derived on every patient
rather than only on those who look high risk on paper. A score of 5 or above in
a patient with no OSA diagnosis raises a warning-tier flag with a recommendation
to screen before the pre-admission clinic, giving the service time to act.