Digital STOP-BANG questionnaire
Digital STOP-BANG questionnaire
Send the STOP-BANG questionnaire digitally to your patients. With Coflow, they answer on their phone or computer before their appointment, with no app and no login.
The count is scored the moment they submit and banded low, intermediate or high risk. The score is waiting for you on the task, and responses write back to your practice management system.
STOP-BANG
Snoring? Do you snore loudly (loud enough to be heard through closed doors or your bed-partner elbows you for snoring at night)?*
Nothing selected
Yes
No
- Sent by SMS or email
- Completed
- Scored
- Filed to your PMS
Try the digital STOP-BANG questionnaire
Coflow forms are flexible and mobile responsive. Patients fill it in on any phone or computer, with no app and no login. Scored forms are scored automatically when the patient submits.
Ready to send it digitally?
Add your logo and send STOP-BANG to patients by SMS or email with Coflow. Book a demo and we’ll set it up with you.
STOP-BANG questionnaire
Obstructive sleep apnoea screening
Please answer yes or no to each of the following questions about your sleep and your health.
| Question | Yes | No | |
|---|---|---|---|
| 1 | Snoring? Do you snore loudly (loud enough to be heard through closed doors or your bed-partner elbows you for snoring at night)? | 1 | 0 |
| 2 | Tired? Do you often feel tired, fatigued, or sleepy during the daytime (such as falling asleep during driving or talking to someone)? | 1 | 0 |
| 3 | Observed? Has anyone observed you stop breathing or choking/gasping during your sleep? | 1 | 0 |
| 4 | Pressure? Do you have or are being treated for high blood pressure? | 1 | 0 |
| 5 | Body mass index more than 35 kg/m²? | 1 | 0 |
| 6 | Age older than 50 years? | 1 | 0 |
| 7 | Neck size large? (Measured around Adam's apple.) For male, is your shirt collar 17 inches / 43 cm or larger? For female, is your shirt collar 16 inches / 41 cm or larger? | 1 | 0 |
| 8 | Gender male? | 1 | 0 |
Scoring the STOP-BANG
For the practitioner. Detach before handing the questionnaire to a patient.
- Each answer scores the number printed beside it.
- Add up items 1–8. The score runs from 0 to 8.
- Find the score’s band in the table further down.
- If any question is unanswered, don’t score the form.
| Scale | How | Range | Score | Band |
|---|---|---|---|---|
| Obstructive sleep apnoea risk | Add up items 1–8 | 0–8 |
| Obstructive sleep apnoea risk | Score |
|---|---|
| Low risk | 0–2 |
| Intermediate risk | 3–4 |
| High risk | 5–8 |
STOP-BANG is a screening count, not a diagnosis. UHN also rates a patient high risk on 2 or more STOP answers plus male sex, a BMI over 35 or a large neck, whatever the total: check those combinations yourself.
Send STOP-BANG digitally
Patients answer on their phone or computer before they arrive, with no app or login. Coflow sends a reminder if they don’t finish, scores it the moment they submit, and files it into your PMS.
- Scored automatically
- Automatic reminders
- Writes back to your PMS
We’ll show you STOP-BANG in Coflow and set it up with you.
Start with the free PDF
We’ll email you the printable STOP-BANG questionnaire and its scoring guide, plus a few ideas for moving your questionnaires online when you’re ready.
On its way. Check your inbox, or download it now.
Download the PDFForm title
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- and more: Nookal and Cliniko
Ready to send your forms digitally?
Book a demo and we’ll show you how Coflow sends forms by SMS or email, collects e-signatures and files answers into your practice management software.