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· 4 min read
How to Check Your Sleep Apnoea Risk Factors
Manesh Jayawardhana
CIO & Co-founder
Obstructive sleep apnoea is unusual among common conditions in that the person who has it is often the last to know. The symptoms happen while you’re asleep, and the daytime effect — persistent tiredness — is easy to attribute to almost anything else.
Usually it’s a partner who raises it, having spent months listening to snoring interrupted by silences.
What the risk factors are
The STOP-BANG questionnaire, widely used in pre-operative screening, checks eight factors. Four are reported, four are measured.
Reported: loud snoring; daytime tiredness; observed breathing pauses; high blood pressure.
Measured: BMI over 35; age over 50; neck circumference over about 40 cm; male sex.
Neck circumference is worth explaining, because it looks arbitrary. It correlates with airway crowding better than BMI alone does — the mechanism of obstructive apnoea is soft tissue collapsing into the airway during sleep, and neck measurement is a reasonable proxy for how much tissue is there.
Three or more factors present is the usual threshold for considering further investigation. That threshold is deliberately low.
Why screening tools over-flag on purpose
A screening questionnaire is designed to catch nearly everyone who has the condition, accepting that it will also flag many people who don’t. That’s the correct trade-off when the condition is common, under-diagnosed, and has real consequences — untreated moderate to severe sleep apnoea is associated with cardiovascular risk and with daytime sleepiness serious enough to affect driving.
The practical implication: a high score is not alarming in itself. It means the questionnaire has done its job and the next step is a proper assessment.
Why people get stuck here
- Snoring assumed to be the whole story. Most snorers don’t have apnoea; it’s snoring plus observed pauses and daytime sleepiness that matters.
- No one to observe. People who sleep alone often have no idea whether they stop breathing.
- Tiredness normalised. Years of poor sleep become the baseline, and “I’m always tired” stops registering as a symptom.
- Fear of the treatment. Reluctance to be assessed because of what CPAP looks like, which is a poor reason to leave it untreated.
What to do with a high count
Ask for a referral
A sleep study is the diagnostic step — either at home with a portable monitor or in a sleep laboratory, depending on the health system and the complexity of the case.
Record what you can
A partner’s observations, or a night recording, are genuinely useful information for a clinician. So is a fortnight of noting how you feel during the day.
Don’t wait for it to get worse
Untreated apnoea doesn’t resolve on its own, and the daytime sleepiness has consequences beyond feeling tired — including at the wheel.
| Factor Type | Examples | Who Can Report It |
|---|---|---|
| Reported | Snoring, pauses, tiredness | You and a partner |
| Measured | BMI, neck, age, blood pressure | You, with a tape measure |
| Threshold | 3 or more factors | Discuss with a doctor |
Common mistakes to avoid
- Dismissing the possibility because you’re not overweight — apnoea occurs at normal BMI, particularly with a crowded airway.
- Relying on your own sense of how well you slept, which is unreliable by definition.
- Treating persistent daytime sleepiness as normal after years of it.
- Using a questionnaire result to rule the condition out.
- Continuing to drive while significantly sleepy — many licensing authorities require this to be reported.
How to do it with Sleep Apnea Risk Check
The Sleep Apnea Risk Check works through the reported and measured factors, with nothing stored.
- Answer honestly about snoring and pauses — a partner’s observation is more reliable than your own.
- Add the measured factors: neck circumference, BMI, blood pressure, age.
- Read the count and which factors are contributing.
- Take three or more factors to a doctor and ask about a sleep study.
The NHS sleep apnoea guidance covers symptoms and treatment options. Other health screening tools are in the tools directory.
Frequently asked questions
Does snoring mean I have sleep apnoea?
No. Most snorers don’t. It’s the combination — loud snoring, observed breathing pauses, and daytime sleepiness — that warrants investigation.
Why does neck circumference matter?
It correlates with airway crowding better than BMI alone, and airway crowding is the mechanism of obstructive apnoea. That’s why questionnaires ask for it separately.
Can a questionnaire replace a sleep study?
No. Screening tools are deliberately over-inclusive so few cases are missed, which means many people who score high don’t have the condition. Diagnosis needs a sleep study.
Final thought
If a partner has mentioned the silences, that observation is worth more than any questionnaire. Take it to a doctor and let the sleep study answer the question properly.