Long working hours and exciting social lives are part of modern day living and many of us do burn the candle at both ends. Most people need 6 to 8 hours of sleep per night to feel refreshed, however some people feel constantly tired, no matter how many hours they spend in bed.

Daytime sleepiness, fatigue, frequent desire for naps, morning headaches, irritability, insomnia, poor memory and concentration can lead to problems at work and within the family, however,  despite a busy social and work life these symptoms may not necessarily be the result of an enthusiastic lifestyle.

Obstructive Sleep Apnoea (OSA) is a common, often under-diagnosed condition which results in sufferers getting insufficient periods of good-quality deep sleep whilst apparently asleep in bed. 

Most commonly the disorder is caused by obstruction and collapse of the upper airway during sleep which results in complete cessation of breathing for 10 seconds or more (apnoea) during which time no air passes into the lungs. This in turn lowers blood oxygen levels and the  sufferer moves from a deep level of sleep to a shallower one. This cycle of events can repeat itself many times during the night, thereby completely disrupting normal sleep patterns. 

In some cases sufferers wake up completely, but in others the airway is only partially obstructed, reducing airflow significantly but not waking the patient. Whilst not as severe as complete apnoea, hypopnoea also disrupts the level of sleep. In most cases there is a combination of apnoea and hypopnoea. 

OSA is estimated to affect up to 4% of the general population, with men suffering more commonly than women in the under 50s (over the age of 50 the incidence is the same for men and women). 70% of people who are obese experience OSA and the condition worsens as BMI increases, but other anatomical disorders of the mouth, throat and neck can also cause the condition. 

It is estimated that only about 10% of people with OSA are receiving treatment. 

Disrupted nocturnal sleep results in poor concentration, slow thinking and poor memory during the day. Studies have shown that this can result in more accidents in the work place. People suffering from OSA having a three-fold increased risk of having a car accident when compared to the general population. If untreated, OSA is also associated with an increased risk of developing other medical conditions such as hypertension (high blood pressure), stroke, heart failure and cardiac rhythm abnormalities, which may lead to premature death.

If you think you may be suffering from sleep apnoea, contact our reception team to book an appointment with our specialist physician Dr Haider.

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Your Specialists

Mr Julian Danino

Consultant Rhinologist and Paediatric ENT Surgeon

Areas of expertise

Mr Danino has a wealth of experience in both general adult and paediatric ENT conditions. During his broad training, he has specialised in Nose & Sinus Conditions and Paediatric conditions such as speech delay and hearing concerns. • Children’s (Paediatric) ENT- Speech Delay and Hearing concerns. Recurrent Ear, Nose and Throat infections. Snoring and Sleep Apnoea management in Children. Paediatric Airway, Voice and Swallowing disorders. Nose, Sinus & Breathing conditions. Nose operations (Septorhinoplasty, Septoplasty and Sinus Surgery). Snoring and Sleep Apnoea management in Adults. Nose and Sinus conditions including nasal obstruction, sinusitis & rhinitis. • Allergy Services- Evaluation and treatment of Ear, Nose and Throat allergies. Skin & Blood testing for all Aero (dust, animals & flora) and Food allergens. • General o Assessment and management of oral (mouth & tongue) lesions. Assessment and reconstructive surgery of facial skin lesions. Ear Services. Adult and Paediatric assessment and management of Hearing & Ear conditions. Vestibular and Balance conditions and their management.

Education and professional training

Mr Danino was born in Gibraltar and is dual qualified in both Dentistry and Medicine selected Summa Cum Laude in his medical graduation year. He went through national selection and specialised in ENT (Ear, Nose & Throat); training and working during more than 20 years in the NHS and Overseas (New Zealand) before being headhunted and joining the GHA in September 2018. Mr Danino is both UK (GMC) and Gibraltar (GMRB) registered. He undertook further periods of further ENT subspecialisation both in UK and abroad (New Zealand) where he was selected for an international fellowship in Paediatrics and Rhinology (Nose & Sinus conditions).

Professional Qualifications, Associations & Accomplishments

MSc, FRCS(ORL-HNS), DOHNS, MRCS, MFDSRCS, BDS, MBBCh(Hons) • Fellow of the Royal College of Surgeons of Edinburgh. • Member of the ENT UK Association of the Royal College of Surgeons England. • British Medical Association (BMA) • European Paediatric ENT Society (ESPO) • BRS and FPS ENT UK • Medical Protection Society registered.

Professional experience

Within the GHA Mr Danino leads the Paediatric and Rhinology (Nose) ENT Services having established close links with the Great Ormond Street and Evelina Hospitals (Paediatric) and Charing Cross Hospital at Imperial College (Nose/Rhinology). He is a key stakeholder in the ENT & Paediatric Multidisciplinary Team within St Bernard’s Hospital which links with GHA Allied health care professionals (SLT, Audiology, Dieticians) as well as external providers (Evelina Hospital, UCLH & Great Ormond Street Hospitals).

Languages spoken

English and Spanish


Short tenure within the GHA he has been the Clinical Lead of the transformation project for the ENT & Audiology Depts. and also chaired the Gibraltar Doctors Advisory committee He has authored numerous publications on ENT topics, Medical Education and Patient Safety; presenting at both National and International meetings and was a Senior Clinical Lecturer at Otago University, Dunedin, New Zealand.