Reference — Respiratory
STOP-BANG OSA Screening Reference
Eight quick yes/no questions that flag patients at risk for obstructive sleep apnea — especially valuable before surgery or sedation, where undiagnosed OSA raises the risk of respiratory depression.
Educational use only. STOP-BANG is a screening tool, not a diagnosis; a positive screen prompts evaluation and precautions. Thresholds and protocols are facility-specific. This reference is an educational aid. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
The Eight Criteria
| Item | Question (Yes = 1 point) |
|---|---|
| S — Snoring | Loud snoring (louder than talking / heard through a door)? |
| T — Tiredness | Daytime tiredness, fatigue, or sleepiness? |
| O — Observed apnea | Anyone observed you stop breathing/gasp/choke in sleep? |
| P — Pressure | High blood pressure (or treated for it)? |
| B — BMI | BMI greater than 35 kg/m²? |
| A — Age | Age over 50? |
| N — Neck | Neck circumference greater than ~40 cm (16 in)? |
| G — Gender | Male? |
Scoring & Risk
Count one point per “yes.” In general: 0–2 = low risk, 3–4 = intermediate risk, 5–8 = high risk for moderate-to-severe OSA. A higher score should prompt sleep-medicine referral and heightened perioperative caution.
Why It Matters Perioperatively
Patients with (or at risk for) OSA are highly sensitive to opioids, benzodiazepines, and anesthetics, which can cause post-operative airway obstruction and respiratory depression. A positive screen should trigger cautious sedation dosing, continuous SpO₂ (± capnography) monitoring, head-of-bed elevation, and use of the patient’s home CPAP postoperatively, plus clear communication of OSA status in handoff.
NCLEX Pearls
- ✦STOP-BANG = Snoring, Tiredness, Observed apnea, Pressure (HTN), BMI >35, Age >50, Neck >40 cm, Gender (male).
- ✦Higher score = higher OSA risk (≥5 = high risk); it screens, it doesn't diagnose (sleep study confirms).
- ✦A positive screen before surgery → cautious opioids/sedatives + continuous monitoring + CPAP.
- ✦Undiagnosed OSA + sedation = a leading cause of post-op respiratory depression.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with American Association for Respiratory Care (AARC) · GOLD (COPD) / ATS / CHEST. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →