Sleep Apnea Risk Test: A Self-Report Screener, Not a Home Sleep Study

Eighteen statements are graded from 0 to 3. The twelve statements about your nights and your days run from never or rarely up to almost always. The six risk factors carry their own answer choices, so your age, collar size, weight change, blood pressure, evening alcohol and nasal breathing each land on one of four graded levels rather than a yes or a no. That matters because risk factors are rarely all-or-nothing: being eleven pounds heavier than you were at twenty-five is not the same as being sixty pounds heavier, and a questionnaire that asks only yes or no throws that difference away.

Each of the three areas can reach 18 points and the total runs from 0 to 54. The four bands are low risk signs at 0 to 10, some risk signs at 11 to 21, moderate risk signs at 22 to 34, and high risk signs at 35 to 54. Those cutoffs are educational divisions of our own scale, not clinical cutoffs: no published validation study stands behind them, and they should not be compared with the score ranges of a validated screener. The three bars matter as much as the number, because a high total built entirely out of risk factors with no breathing signs and no daytime effect means something different from a moderate total built out of witnessed pauses and sleepiness at the wheel.

The grouping into nighttime signs, daytime consequences and standing risk factors is our own educational structure. It follows the shape of a clinical sleep history rather than a validated factor analysis, and the three bars should be read as a map of where your score came from, not as subscales with known reliability.

This page has no sensor in it. It cannot count how many times your breathing stops or narrows per hour, it cannot measure the oxygen in your blood, and it cannot see your heart rate, your airflow, your chest movement or your sleep stages. Those measurements are the whole basis of a sleep apnea finding, and a questionnaire has access to none of them. The American Academy of Sleep Medicine puts it plainly in its 2017 diagnostic guideline: clinical tools, questionnaires and prediction algorithms should not be used to establish obstructive sleep apnea in adults in the absence of polysomnography or home sleep apnea testing. This screener agrees with that completely, and nothing on this page is a diagnosis.

What does the measuring is a sleep study, and there are two kinds. A home sleep apnea test is a small kit you wear for one to three nights, ordered by a clinician and read by one: usually a finger or wrist sensor plus a nasal cannula and a chest band, recording airflow, effort, oxygen saturation and pulse. In-lab polysomnography is a night in a sleep laboratory with a fuller set of sensors, including brain activity, eye movement and leg movement, which is what makes it the standard test and the right one when the picture is complicated by heart or lung disease, neuromuscular conditions, suspected other sleep disorders, or a home test that came back negative while the suspicion stayed.

The validated questionnaire a clinician is most likely to hand you is STOP-Bang (Chung and colleagues, 2008), developed at the University Health Network in Toronto. It is eight items and it is well studied as a pre-test screen, particularly before surgery. It is not reproduced on this page: the questionnaire is owned by its developers and the University Health Network, and commercial use requires a license from them, so we wrote our own items instead and named theirs. The same goes for the Epworth Sleepiness Scale (Johns, 1991), which measures daytime sleepiness and is proprietary, and for the Berlin Questionnaire (Netzer and colleagues, 1999). All three are named here and none of them is reproduced here.

One limit worth naming. The neck size bands on this page use a single set of thresholds, and the validated screeners use different ones for men and women (17 inches or 43 cm for men, 16 inches or 41 cm for women), as well as counting male sex as a risk factor in its own right. We left sex out of the scoring, which means this screener reads a woman's risk lower than a clinician would. Sleep apnea is already missed more often in women, so if you are a woman with daytime sleepiness and witnessed pauses, treat a middling total here as worth an appointment anyway.

Three very different problems arrive at the same complaint, which is that you are tired. In sleep apnea the sleep time is often normal and the sleep quality is wrecked, because the airway keeps narrowing and each event pulls you briefly toward waking without you remembering it. In insomnia the problem is getting to sleep or staying asleep, and the night is spent awake and aware of it. In a circadian mismatch there is nothing wrong with your sleep at all except when it happens: a late body clock pushed against an early alarm produces exactly the same fog.

They can also coexist, and the combination of insomnia and sleep apnea is common enough to have its own name in the literature. The practical point is that the three have different treatments, so guessing is expensive. If your nights are spent lying awake, our insomnia test Insomnia Test (ISI) fits the pattern better than this one. If the timing is the issue, our chronotype test Chronotype Quiz looks at your body clock. If your sleep looks fine on paper and the tiredness is still there, our fatigue test Fatigue Test and brain fog test Brain Fog Test cover the ground where sleep is not the whole answer, and our sleep quality test Sleep Quality Test is the broader place to start.

One more overlap is worth naming because it is so often missed in both directions: untreated sleep apnea produces low mood, irritability and poor concentration that look exactly like depression, and depression produces tiredness that looks exactly like sleep apnea. If the low mood is the loudest part, our depression test Depression Test is worth taking alongside this one, and tell whichever clinician you see about both sets of answers rather than choosing between them.

If your band is moderate or high, the next step is an appointment, and the thing that makes that appointment productive is specifics. Write down what a bed partner or housemate has actually said, in their words. Note whether you have ever woken gasping, and roughly how often. Keep two weeks of rough sleep and wake times with how you felt in the afternoon. Bring your blood pressure readings if you have them, and your weight now against your weight in your mid-twenties. A result from this page plus that record is the kind of thing that gets a sleep study ordered; a result from this page on its own is a conversation starter.

If you have ever fought to stay awake at the wheel, treat that as the urgent item regardless of your total. Say it out loud to a clinician and stop driving while drowsy in the meantime, because that single symptom carries more immediate risk than the rest of the questionnaire put together.

If your band is low and you are still exhausted, the honest reading is that this screener found little pointing at breathing and the cause is probably somewhere else. That is useful information, not a dead end. Sleep length, insomnia, body clock, iron, thyroid, medication and mood all belong on the list, and a basic set of bloodwork plus two weeks of a sleep diary will narrow it faster than another questionnaire will.