Chapter 01 · The screener
What the STOP-BANG letters mean
The STOP-BANG name encodes its 8 items: Snoring (loud), Tiredness (daytime), Observed (apneas), blood Pressure (high), BMI (over 35), Age (over 50), Neck (over 40 cm), and being assigned male at birth. Each yes adds one point, and the total is your score.1 The instrument was originally validated in surgical patients before anesthesia, but it has since been validated across primary care, sleep clinics, and population screening. It is built to be sensitive, so it deliberately catches more people than truly have OSA.
*12 month plan, billed once for the term when a physician approves. Renews each term.
Chapter 02 · The metabolic link
Why OSA matters for weight loss
This is the connection most patients do not know about. Untreated OSA produces nocturnal low oxygen, fragmented sleep, and elevated cortisol, all of which promote insulin resistance. Multiple studies show that treating OSA with continuous positive airway pressure (CPAP) improves metabolic markers, and untreated OSA can make weight loss harder. One brand-name tirzepatide product is FDA-approved to treat moderate-to-severe OSA in adults with obesity; compounded tirzepatide is not FDA-approved. A physician decides how the two conditions are addressed together. For someone pursuing weight loss who also screens positive on STOP-BANG, addressing OSA in parallel often produces better outcomes than treating either alone.
| Severity | AHI range | What it means |
|---|---|---|
| Mild OSA | AHI 5 to 14 | Fewest breathing events per hour |
| Moderate OSA | AHI 15 to 29 | A common treatment threshold |
| Severe OSA | AHI 30 or more | Most breathing events per hour |
Severity is graded by the apnea-hypopnea index (AHI), the average breathing events per hour on a sleep study.
Chapter 03 · The diagnosis
How OSA is actually diagnosed
A high STOP-BANG score is a pre-test probability, not a diagnosis. The diagnosis requires objective sleep testing: in-lab polysomnography, the gold standard, or a home sleep apnea test (HSAT).3 HSAT is appropriate for adults with a high pre-test probability of moderate-to-severe OSA and no significant comorbidities. The result is reported as the apnea-hypopnea index, and severity follows the table below.
Start here · one question
What's your goal weight?
Choose a goal to discuss with your clinician. You can change it in your intake.
| STOP-BANG score | Risk band | What it suggests |
|---|---|---|
| 0 to 2 | Low | Low probability of moderate-to-severe OSA |
| 3 to 4 | Intermediate | Physician evaluation is appropriate |
| 5 to 8 | High | Evaluation and likely a sleep study are warranted |
A negative screen does not rule out OSA when symptoms are strong; clinical judgment supersedes the score.
Chapter 04 · The options
Treatments for confirmed OSA
First-line treatment is positive airway pressure (CPAP, BiPAP, APAP), which is highly effective with consistent use. Mandibular advancement devices are an alternative for mild-to-moderate OSA. Weight loss has a dramatic effect in many patients with obesity and OSA, sometimes allowing CPAP weaning. Positional therapy, hypoglossal nerve stimulation, and upper airway surgery are options for selected patients. Treatment selection follows the sleep study and is made with a sleep medicine physician.
STOP-BANG is a starting signal, not a verdict. A high score is a reason to begin a workup with a physician, and a sleep study confirms or rules out OSA. Individual results vary.
