Do you know your stop bang score?
Are you even aware of what the stop bang questionnaire is?
Well, allow me to reveal the answers to a short quiz that could literally save your life.
The questionnaire is a very basic (but highly effective) assessment tool that has been used to screen patients for obstructive sleep apnea (OSA).
I have discussed the dangers of sleep apnea in various other articles on this website, and if left undiagnosed and untreated this can have a huge impact on your physical and mental wellbeing.
So, let’s take a more in-depth look at sleep apnea and your stop bang score.
A Quick Review of What Sleep Apnea Is
Sleep apnea is a sleep disorder where your breathing repeatedly stops and starts.
The main symptoms include:
- Loud snoring.
- Your breathing stops while you sleep (typically observed by your partner).
- Gasping or choking while you sleep (you are literally fighting to breathe).
- Awakening with a headache or dry mouth.
- Suffering from insomnia and having difficulties staying asleep.
- Hypersomnia or excessive daytime sleepiness.
- Difficulty in concentrating during the day and feeling irritable
There are a number of types of sleep apnea:
- Obstructive Sleep Apnea – This is the most common form and typically occurs due to a blockage of the airway when your throat muscles relax.
- Central Sleep Apnea – This is when your brain doesn’t send the correct signals to the muscles which control your breathing.
- Treatment-Emergent Sleep Apnea or Complex Sleep Apnea Syndrome – This is when you have both obstructive and central sleep apnea at the same time.
There are various risk factors that can increase your chances of getting sleep apnea
- The risks of obstructive sleep apnea will significantly increase if you are overweight or obese. This typically causes excess fat deposits around the upper airway, which can obstruct your breathing.
- Your neck circumference plays an important role, as people with thicker necks tend to have narrower airways.
- If you have narrowed airways, which can be inherited, or because of enlarged tonsils or adenoids, this can block the airway.
- If you have a family history of sleep apnea this greatly increases the risk for you.
- Allergies or nasal congestion may make it difficult for you to breathe through your nose.
- Sleep apnea is more prevalent as we get older.
- Men are up to 3 times more likely to have sleep apnea than women. Although, the risk of sleep apnea is increased in women if they are overweight, and often after menopause.
- Smoking can increase fluid retention and inflammation in the upper airway, which significantly increase the chances of sleep apnea. In fact, smokers are 3 times more likely to suffer this condition than non-smokers.
- The use of sedatives, tranquilizers and alcohol can act as a relaxant for the throat muscles, which can worsen the symptoms of sleep apnea.
Sleep apnea can also lead to various complications, such as daytime fatigue, sleep-deprivation (and a sleep-deprived partner), high blood pressure, heart disease, increased risk of heart attack and stroke, liver problems, type 2 diabetes, and to be honest, the list could go on.
What’s All This “Stop Bang” Business About Anyway?
“Stop Bang” is a questionnaire that was created to ascertain whether a person is considered a low, moderate or high risk for sleep apnea.
The questionnaire was developed by Dr. Frances Chung of the Department of Anesthesiology and Pain Management at University Health Network, University of Toronto.
Dr. Chung published a paper entitled, “High STOP-Bang Score indicates a high probability of sleep apnea” to celebrate World Anesthesia Day in 2017.
The paper has been widely lauded and was chosen by the British Journal of Anaesthesia as one of the Top 25 Most Important Articles in the history of Anesthesia.
S.T.0.P. – B.A.N.G. is basically an acronym that covers the 8 questions that are asked in the questionnaire to determine your risk of sleep apnea.
The letters stand for:
- Body Mass Index
- Neck Circumference
The Questionnaire and Your Stop Bang Score
Simply answer Yes or No to the following questions:
As you can see the questionnaire is very basic and the scoring system is simple to work out.
So, if you answered 2 or fewer questions with a Yes you have a low risk of obstructive sleep apnea.
If you answered Yes to 3-4 questions you have an intermediate/moderate risk of sleep apnea.
For those of you who answered Yes to 5-8 of the questions you are considered to be at high risk of obstructive sleep apnea.
What Should I Do If I Scored 5 or Above?
If your Stop Bang score was 5 or above your next step should be official diagnosis.
Your doctor will be able to evaluate the likelihood that you have sleep apnea based on your symptoms and your sleep history.
If your doctor believes you have, or are at risk, of sleep apnea you will generally be referred to a sleep disorder center.
A sleep disorder specialist will need to make further tests, which often requires an overnight stay at a sleep center.
The most common test is a nocturnal polysomnography which will involve being connected to equipment that monitors you while you sleep.
This equipment will observe the activity of your heart, brain and lungs, your breathing patterns, any movement of your arms and legs, and your blood oxygen levels.
I know this all sounds a little scary, but often a home sleep test could be a viable option. These tests are far more simple and will measure your heart rate, breathing patterns, airflow, and blood oxygen levels.
However, you should be aware that the home sleep tests may not detect all cases of sleep apnea, and even if your tests return as normal, your doctor may still recommend a polysomnography.
If it is found that you do have sleep apnea you may be referred to an ear, nose and throat specialist in order to ascertain whether you have a blockage in your nose or throat.
Further evaluation by a cardiologist or neurologist might also be necessary to determine the causes if it believed that you have central sleep apnea.
What Treatments Are Available?
There are various forms of treatment for sleep apnea, although what is best for you will very much depend on the severity of your symptoms.
In cases of mild to moderate sleep apnea there are certain lifestyle changes you should undertake.
This may involve losing weight, giving up smoking, changing your drinking habits, using exercises to strengthen the muscles of the throat and airways, etc.
If you have nasal allergies then you should look at a specific course of treatment for this.
Natural treatment should always be your first port of call, as this can help to improve the signs and symptoms of sleep apnea, which rules out the other, far more invasive therapies.
If you are interested in a more natural treatment for sleep apnea you will find my personal recommendation at this end of this article (if you can’t wait any longer, please scroll down and check it out, but don’t forget to come back and read the “other” options available to you).
Continuous positive airway pressure (CPAP)
CPAP is typically the most common method used to treat moderate to severe sleep apnea. It involves using a machine to deliver air pressure through a mask while you’re asleep.
The continuous air pressure will keep your upper airways open, which in turn will prevent snoring and the blockages that lead to sleep apnea.
However, this may be the “most common” method, but it doesn’t come without its faults.
Many people tend to give up using a CPAP machine for a variety of reasons.
The mask may be uncomfortable and ill-fitting, so you may need to try a variety of masks until you find the perfect fit.
With that being said, just the simple task of wearing a mask around your face may disturb your sleep, which will only make your symptoms worse.
The whole process of setting up your machine, turning it on, putting on a mask can become very cumbersome for some.
There are even people who knock the mask off as they move during the night, which pretty much defeats the object.
Then there is the noise, the constant drone of a machine delivering air pressure to you throughout the night.
Don’t get me wrong, CPAP machines have worked wonders for many, many people with sleep apnea, but it will take patience, practice, and getting used to on your part.
There are a number of oral devices that can be used to prevent certain types of snoring and mild sleep apnea.
These devices work by keeping the throat open and bringing your jaw forward.
You will usually need to try a number of devices to ensure a good fit and these are available from your dentist.
Once again, some people may find this uncomfortable (wearing something in your mouth while you’re trying to sleep) and this can only be used to treat sleep apnea if a blockage in your throat is the issue.
An oral device will not work for someone with nasal issues that have led to sleep apnea.
Surgery is typically your final option if all else has failed.
I don’t wish to go into too much detail here as there are a number of articles on this website dedicated to surgery for sleep apnea.
Some of the surgical options include:
- Tissue shrinkage
- Repositioning of the jaw
- Nerve stimulation
- A tracheostomy (this will only be an option if all other treatments have failed and your sleep apnea is considered life-threatening).
So, as you can see your Stop Bang Score is simply the first step in determining whether you have sleep apnea.
We have talked about the symptoms, risk factors, and types of sleep apnea.
We have discovered that Stop Bang is an acronym which covers the 8 questions that are asked in the questionnaire.
Then finally there was the medical diagnosis and various treatments for sleep apnea.
I mentioned that a natural course of treatment should always be your first option, I mean why would you want to go through using certain contraptions, machines, and possibly even surgery, if you don’t have to.
You can read my review of the Snoring and Sleep Apnea No More Program here, which is my recommendation for the best natural treatment for sleep apnea (plus there is a special surprise just for my readers).