![]() Rpi-eeprom/stable 13.13-1 armhf īut if there are no newer versions of packages or dependencies in your distro's software repository, you'll see an output like this: $ sudo apt-get update If you want to see which packages can be upgraded, run apt list -upgradable: $ apt list -upgradable Get:6 buster/main armhf Packages ģ packages can be upgraded. If there are updates, you'll see an output similar to this: $ sudo apt-get update In the terminal, enter sudo apt-get update in the command line, enter in your admin password, and press the Enter key. For example, in Ubuntu and Linux Mint, the default terminal is Gnome Terminal, but may be listed under Terminal in the application menu. In your Debian-based Linux distro (Debian, Ubuntu, Linux Mint, Kali Linux, Raspberry Pi OS, and so on), open a terminal window.ĭepending on your distro, the terminal might go by different names depending on how you open it. How to Use the sudo apt-get update Command But just running sudo apt-get upgrade will not automatically upgrade the outdated packages – you'll still have a chance to review the changes and confirm that you want to perform the upgrades. The sudo apt-get upgrade command downloads and installs the updates for each outdated package and dependency on your system. In other words, it'll figure out what the latest version of each package and dependency is, but will not actually download or install any of those updates. The main difference is that sudo apt-get update fetches the latest version of the package list from your distro's software repository, and any third-party repositories you may have configured. ![]() What Are the Differences Between sudo apt-get update and sudo apt-get upgrade? In this article, I'll go into what both of these commands do, how to use them, and some frequently asked questions. They're common commands for Linux admins and people doing DevOps, but are handy to know even if you don't use the command line often. Sudo apt-get update and sudo apt-get upgrade are two commands you can use to keep all of your packages up to date in Debian or a Debian-based Linux distribution. ![]()
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![]() ![]() How would you rate this page? (question 1 of max 3) Bad Poor Good Very good Excellent Related articles Clothing suitable to wear outside of work must have your company logo. That is clothing that you wear exclusively in the context of your business. But aso participating in business congresses and seminars, including travel costs. Promotion and representation costsĭo you spend money to promote or represent your business? For example, with a website, business cards, business gifts, or business lunches. You can deduct these insurance premiums from your profit. For example, a business or professional liability insurance. Insurances you take out for your business are business expenses. Learn more about the deduction of study costs for work (in Dutch). ![]() You can also deduct costs for specialist literature. For study costs made simply to learn something new, consider applying for the STAP budget for training and development. Study costs that are made to keep up to date with specific knowledge needed for your business can be deducted from your profits. The Dutch Tax and Customs Administration has a tool (in Dutch) to help you calculate what costs you can deduct for a workspace in your home. Running a business from your homeīusiness expenses for a workspace in your home cannot usually be deducted. Business locationĭo you have business premises? For example, an office, factory, shop, or workshop? Learn more about what costs are deductible for your business premises. The Dutch Tax and Customs Administration ( Belastingdienst) calls this an input tax deduction. You can usually deduct the VAT you pay on your business expenses in your VAT return. To do so, you divide the costs over the years in which you use the asset. Sometimes you must spread the deduction over several years, such as when buying a company car. Deductions that must be spread across multiple years Read more about expenses you can deduct in 1 year (in Dutch). Many business expenses can be deducted at once but business assets must be spread over several years: Deductions that must be made in 1 yearĬosts that you incur in 1 year can be fully deducted in the same year. If you have costs that relate to both business and personal uses, you can only deduct the business part (in Dutch). For example, costs for registering in the KVK Business Register. These start-up costs are sometimes deductible. There are also costs related to starting a business. These costs are also called business expenses. Such as the rental costs for business premises or costs for an internet subscription. You can only deduct the costs that you make for your business. ![]() ![]() ![]() If your device's OS version is lower than Android 6.0, you cannot choose whether to allow access permissions or not. Camera: Used for taking photos for the share group cover photo.Storage: Used for transferring or saving photos, videos, or files to a device.Calendar: Read the Calendar schedule and details.Address book: Used for updating profiles of friends in saved Contacts or selecting a recipient list.Telephone: Used for checking the device that the user is logged into.SMS: Used for sending an authentication text message at the sign-up stage and automatic entry of the authentication number.In the case of optional access permissions, basic features of the service can be used even if they are not granted. * If the Group Sharing app is not updated or deactivated, some features of Samsung apps may not operate properly.Īccess permission as follows is required to offer the service. Share profile photos on the Contacts App.Create and manage share groups from the Samsung account’s Group Sharing menu.Group Sharing app provides a variety of features to share content, and is constantly improving its usability through continuous updates. ![]() You can also share profile photos with your friends on the Contacts app. It is an application that allows you to share a variety of content with your family and friends on Samsung’s basic apps such as Gallery, Samsung Note, Calendar, and Reminder by using the share groups of Samsung accounts. Group Sharing app is installed on Samsung Galaxy devices as a basic app. ![]() ![]() ![]() ![]() $9.99 Aussie Steak Tacos: Two grilled steak tacos topped with crispy slaw, pico de gallo, melted cheese and an herb aioli served with choice of soup, signature salad or side. ![]() $8.99 Aussi Fish Tacos: two blackened fish tacos topped with crispy slaw, fresh pico de gallo and herb aioli served with choice of soup, signature salad or one side.$7.99 Aussie Chicken Tacos: Two grilled chicken tacos with crispy slaw, fresh pico de gallo, melted cheese and an herb aioli served with your choice of soup, signature salad or side.$7.99 Walhalla Pasta: Fettuccine noodles and mixed veggies tossed in a creamy Parmesan cheese sauce served with choice of soup, signature salad or side.Paired with Creole marmalade served with choice of soup, signature salad or side. $8.99 Coconut Shrimp: six shrimp hand-dipped in batter, rolled in coconut and fried.$9.99 ½ Ribeye Melt: Tender ribeye topped with grilled onions, crispy bacon, melted Cheddar cheese and garlic aioli, served on a toasted artisan bun served with choice of soup, signature salad or one side.$7.99 Alice Springs Chicken Quesadillas (small): stuffed with fresh grilled chicken breast, sautéed mushrooms, bacon, melted cheeses and honey mustard sauce served with choice of soup, Signature Side Salad or one side.$7.99 Endless French Onion Soup and Salad: a bowl of French Onion Soup made with onions and topped with melted Provolone cheese and your choice of House or Caesar Salad.$6.99 Endless Soup and Salad: a bowl of fresh made soup and your choice of a crisp House or Caesar Salad.Add your choice of cheese: American, Swiss, Provolone or Cheddar for $1.00. $8.99 The Outbacker Burger: topped with lettuce, tomato, onion, pickle and mustard.* Prices and specials may vary by location Happy Hours of Operation (Varies by location) 5 pm to 7 pm daily That is cuisine.What Does Outback Steakhouse Offer During Happy Hour “Every morning one must start from scratch, with nothing on the stoves. “My hope is to educate the average diner on the fine art of eating well.” - Chef Ronnie Killen “I want your dining experience at Killen’s Steakhouse to be unmatched enjoying great cuisine at a great value.” Ronnie’s passion for food and amazing attention to detail is evident in every aspect of his restaurant as he continues to break the mold of stuffy fine dining and constantly brings innovation to the Houston dining scene. Ronnie also had his signature dessert, Crème Brulee Bread Pudding, named one of the Top Ten Dishes in the United States by Food and Wine magazine in 2008. Since it’s inception in 2006, Killen’s has gained numerous awards and achieved resounding praise even being called the “Ultimate Steakhouse” by the Houston Chronicle and was named one of Texas best steakhouses by Texas Monthly. Ronnie’s love of fine dining brought him home once more as he opened the acclaimed Killen’s Steakhouse in his hometown of Pearland, Texas. This process usually takes a year or more and is an honor only held by approximately 1200 chefs across the United States. Chef Killen still considers this honor to be one of the highlights of his illustrious culinary career.Ģ005 was a banner year for Chef Killen as he was named a Certified Executive Chef by the American Culinary Federation, after only five months of examinations and practicals. He was, however, asked by the new Executive Chef to interview for the title of Assistant Executive Chef. He was a finalist but was not ultimately chosen. In February of 2005 Ronnie was awarded the opportunity of a lifetime, a chance at the position of Executive Chef at the White House. During his tenure at Brenner’s, the steakhouse was awarded the title of “Best Steakhouse” by the Houston Press and the Business Journal. You can’t keep a native Texan away for long and in 2003 Ronnie returned home, accepting the post of Executive Chef at Brenner’s Steakhouse. Since graduating Ronnie has added numerous accolades to his resume while working as such fine hotels and resorts as: The Omni Mandalay in Irving, Texas, Big Cedar Lodge in Ridgedale, Missouri and The Ritz Carlton in Rancho Mirage, California. ![]() ![]() ![]() In the case of the knowledge analyst, that is a total joke. In most of these analyst jobs or roles, there is little analysis taking place. In addition to business analyst, and its confused cousin process analyst, we now have change analyst, data analyst, operations analyst, you name it, and most recently the most wicked job title of all, the “knowledge management analyst”, and oh, not to mention, the stakeholder analyst. There is also a new and strange phenomenon sweeping the business world today-job titles with the suffix “analyst” attached to them. We are already witnessing it in business process analysis and business analysis and the overlap and confusion has never been worse. In a similar vein, the COVID-19 pandemic is rapidly becoming another turning point in the downfall of professional standards and ethics and the demise of some professions. Missing luggage is one thing, and process defects are allowed to a certain degree, but a plane falling from the sky is quite a serious matter. Even in the aviation industry, the zero-defect policy has been scaled down, and it is not unusual to hear about a plane door coming off while the plane is in flight. We will fix it later, in the next release. Many companies have since then gradually abandoned methods and frameworks, such as total quality and zero-defect, in favour of hodgepodge products and services. The Y2K was a turning point in quality assurance. Quality is out of the door-that is for sure-and in the haste to roll out products and to transform the business into whatever monstrosity they choose, in pseudo-agile settings, the baby is thrown out with the bathwater. So, years of effort by champions and leaders of professional education to develop true professions and raise professional standards have been undermined, especially in the newly established ones, and have been hijacked by dollar-hungry agencies and short-sighted employers, who seem to have embraced the new doctrine of “better done than perfect”. ![]() It has also shown the poor standards of both professionals and businesses and a pronounced lack of social and professional maturity, with the so-called professionals acting like seventh grade students. Not just the agencies, but also companies. And we are back to cutthroat practices and desperate people accepting lower wages, in a prelude to further erosion of professional recognition and standards, along with the living standards of impacted groups. Where there is chaos, there is opportunity. The sudden impact of the pandemic on social and business behaviour has produced a range of responses, both positive and negative, and there is no shortage of chancers and exploiters of this global human tragedy. In fact, up until now, the gulf has been widening as the gains trade union movements achieved to improve the work conditions and treatment of workers has been eroding gradually (minimum wages, working hours, sick leave, annual leave, superannuation, etc). Decades of distrust in organisations have entrenched a culture of suspicion and the “them and us” divide between management and employees has never been bridged. Despite the life-work balance that employers have been advertising in their glossy brochures, only the privileged few enjoyed this perk, as considered so by management, mostly the favoured and protected groups. It took a disaster of the magnitude of COVID-19 pandemic to make organizations allow their workforce to work from home. “Those who expect perfection in others should examine their own imperfections first.” ![]() ![]() ![]() At the age of 20, he and a record producer Jadion worked together to deliver a theme song for the Flashback, an annual Disneyland Resort event. ![]() Despite not understanding him and him being reluctant to call his parents to tell them, he booked his 1st show as a musician in a gay club in Los Angeles and his dad told him “they wouldn’t miss it for the world.”.Ironically, that person told him he needed to be “less gay” and to “butch it up immediately.” A male manager at Untitled Entertainment manipulated and pressured him into performing s*xual acts on him, which continued for a while.Shortly after his move to Los Angeles, Simon signed with Untitled Entertainment, the biggest management company in Hollywood at the time.When he was 18 years old, he also entered a “Get Famous” contest by Popstar Magazine and got the chance to meet with a record producer Johnny Wright as a prize.He moved to Los Angeles, California, United States at the age of 18.His sister-in-law sneaked him in to see his mom a day before he boarded the plane to Oklahoma, the United States to visit his best friend. His family stopped him from seeing her in the hospital because they blamed him for what happened. Simon’s mom attempted suicide after she found out he was gay.Simon’s parents didn’t understand his s*xual preference and told him they wished he had died from leukemia and regretted praying for his survival.His dad worked in the military while his mom was a devout Catholic, so “gay” and “queer” were considered dirty and perverted words. His older brother broke the news of him being gay to his parents.At the age of 10, Simon was diagnosed with leukemia.He spent his earliest years of life in Alpena, Michigan, United States before he and his family moved to Tulsa, Oklahoma, United States.Simon Curtis in a selfie as seen in December 2019 (Simon Curtis / Twitter) Simon Curtis Facts Including contributions from Rita Abrahamsen, Roland Bleiker, Antoine Bousquet, Christian Bueger, David Chandler, Stephen Collier, Olaf Corry, Xavier Guillaume, Graham Harman, Debbie Lisle, Maximilian Mayer, Aihwa Ong, Mark Salter, Saskia Sassen, Peer Schouten, Nick Srnicek and Michael Williams, this text will appeal to scholars in International Relations, Political Sociology and Human Geography.65 kg or 143.5 lbs Simon Curtis as seen in December 2019 (Simon Curtis / Twitter) Race / Ethnicityĭark Brown Simon Curtis in a selfie in December 2019 (Simon Curtis / Twitter) Sexual Orientation It draws on a variety of international relations experiences and on conversations with key 'assemblage' theorists to tease out the theoretical and methodological implications, ontological and material dynamics, as well as the politics of assemblage thinking. Can parallel developments be prompted in IR? Reassembling International Theory investigates how the contemporary debates on assemblages in social theory can contribute to generating critical considerations on the connections and dissociation of political agency, physical world and international dynamics. What can 'assemblage thinking' contribute to international theory? Assemblages have been invoked in several disciplines to make sense of the heterogeneity of the elements of society and the ways in which these are politically intertwined. ![]() ![]() ![]() But they’re almost too late: Shortly after the Nautilus plows down the canals looking for explosives, underwater bombs start going off that start the city tumbling down, and only some heroic fast-thinking prevents its total destruction. In this time when secret technology far outstrips that visible in everyday life, the group is able to speed to Venice on Nemo’s enormous and elegant Nautilus submarine, which looks 10 times the size of the beauty featured in “20,000 Leagues Under the Sea” nearly 50 years ago. The obviously artificial but vividly rendered look most recalls those of Alex Proyas’ “The Crow” and “Dark City,” except set in recognizable turn-of-the-20th-century Europe. ![]() Dark, gilded and resplendent with the trappings of empire at its height, the innumerable settings created by production designer Carol Spier, abetted by arresting natural locations and the work of more than a dozen visual effects houses, create an alluring environment rooted firmly in the past but edging into the future. For starters, there are large egos involved, not to mention some back story: Quatermain distrusts the “pirate” Nemo Mina Harker and Dorian Gray had an affair some years back Skinner and Jekyll/Hyde are outcasts of dubious standing and all have questionable loyalty to, or enthusiasm for, the Crown.īut more striking still is the world these living legends inhabit. Hyde (Jason Flemyng) and last and, under these circumstances, definitely least, Tom Sawyer (Shane West), the former Mississippi River rat who turns up here as a member of the Secret Service.Įven if these characters mean little or nothing to many viewers, they are introduced with a certain brio by “Blade” director Stephen Norrington, working from a screenplay by James Dale Robinson that warmly embraces but doesn’t overdo the literary refs already in place in the comicbooks by Alan Moore and Kevin O’Neill. They are: the Indiana Jones of his time, legendary hunter-adventurer of “King Solomon’s Mines” Allan Quatermain (Sean Connery, who might as well be playing the old James here) Jules Verne’s brilliant underwater nomad Captain Nemo (Indian cinema vet Naseeruddin Shah) Oscar Wilde’s ageless and indestructible aesthete Dorian Gray (Stuart Townsend) the equally invulnerable scientist-turned-vampire Mina Harker (Peta Wilson) invisible man Rodney Skinner (Tony Curran) the brilliant Dr. It thus comes as a shock to late Victorian London when a terrorist known as the Fantom is able to invade the Bank of England with a tank and, after destabilizing the continent, plots to blow up Venice during an emergency conference there among all the Euro heads of state.īut given the lack, back then, of what we now know as superheroes, or even of someone like James Bond, a British gent with the conspicuous name of M (Richard Roxburgh) gathers together several famous and variously gifted figures to stop the Fantom in the four days that are left before the gathering on the lagoon. future for this obviously pricey 20th Century Fox release.Īfter a century marked by mass annihilation or the threat of it, and by tyrants who wreaked havoc on an unprecedented scale, “League” harks back to a time - 1899 - when violent evil perhaps had narrower, more specific targets. The answer is almost certainly no, which spells a dicey B.O. ![]() Commercially, one must begin by asking whether the international youth audience will be much interested in a picture populated by such 100-plus-year-old names as Allan Quatermain, Dorian Gray, Jekyll and Hyde, Captain Nemo and, of all people, Tom Sawyer. The dawn of the age of superheroes and weapons of mass destruction is imagined in fanciful but literally overblown terms in “The League of Extraordinary Gentlemen.” Operating from a disarming premise that brings together several of the late 19th century’s most celebrated literary figures to battle an evil mastermind of unprecedented ambition and technological means, this highly elaborate venture offers some appealing elements - exceptionally beautiful design, atypical characters, literacy and an intriguing intellectual basis - that are ultimately engulfed by explosions, effects and an affiliated ponderousness. ![]() ![]() ![]() Multi-millionaire Just Stop Oil donor Dale Vince says eco-zealots will continue disruption at 'high-profile' sports - as Silverstone boss warns of 'serious injury or death' if protesters interrupt an F1 event ahead of British Grand Prix.King 'deliberately' put Kate and William 'front and centre' of his Scottish Coronation to 'project the future of the monarchy', royal expert claims.Journey co-founder George Tickner is dead at 76: Original guitarist with legendary band left to become a doctor.Brit who entered woman's home, soiled himself and was caught rummaging through her bedroom looking for clothes to wear after a night out in Spain is cleared of trespass after blaming extreme diarrhoea.Wagner chief is made toupee for challenging Putin! Humiliating images of Prigozhin 'wearing wigs and laughable disguises' are leaked after raid on his mansion.as Belarus dictator says he is back in Russia. ![]() ![]() Ex-female prison nurse, 55, who helped her murderer lover escape from open prison is struck off after being spared jail sentence.Four retired Met Police detectives accused of misconduct over botched Stephen Lawrence inquiry WON'T face criminal charges because of insufficient evidence, CPS rules.Gang member who raped, tortured and murdered young woman on the orders of her father in 'honour' killing that shocked Britain is still too dangerous to be released and deported.'Cannibal' Mexican husband 'killed his wife, ate her brains in tacos and used her skull as an ashtray'.Ricky Martin SPLITS from husband Jwan Yosef: Singer reveals six-year marriage is 'ending with love, respect and dignity' as they vow to maintain a 'healthy family dynamic' for their kids.'It was a completely different world before MeToo': Kevin Spacey's alleged victim tells court that he didn't come forward with claims he was sexually assaulted because actor was 'shining light of the West End'.Gary Neville admits making 'huge mistakes' over plans for £400m Manchester development including bid to tear down iconic pub - as he defends its lack of affordable housing.'Joe's being a d***': Tories urge Rishi Sunak to block 'anti-British' Biden's bid to install 'disaster' EU chief Ursula von der Leyen as next head of Nato - amid claims US president wants to punish PM over Ukraine pilot training deal.Dad sparks furious debate after revealing he is REFUSING to pay for his daughter's wedding because she won't let him walk her down the aisle.Cabinet Office LOSES legal challenge against handing over uncensored versions of Boris Johnson's WhatsApps and documents to Covid Inquiry.Girl, 8, is killed and female driver is arrested after Land Rover crashes into hall of £16,000-a-year all-girls Wimbledon school: 16 are injured including 10 rushed to hospital after pupils as young as four were enjoying last day of term tea party.Do you live in a burglary hotspot? More than 500 homes burgled every day - we reveal which areas have had the biggest uptick in the past year.after taking a 136-mile trip by helicopter to Glastonbury Furious viewers brand Holly Willoughby an 'eco-hypocrite' for sympathising with Just Stop Oil.Truth behind THAT awkward 'mum's day out': As Kate returns to the polo to support William, how her 2019 outing with Meghan was an effort to show a united front before their feud was exposed.Furious single mother sends her son's teachers an angry email over 'utterly ridiculous' cost of school trip to Poland.Princess of the polo! Kate is every inch the proud wife as she dons £550 baby blue Beulah midi dress to support William at charity match.Everything must go! One of Britain's richest aristocrats put his entire 9,500-acre estate on the market - including caravan site and a pub - for £35m in England's largest land sale.'How on earth did we get to point where we find ourselves in court to defend what a lesbian is?' LGB Alliance defeats bid by trans charity Mermaids to strip it of its charitable status.Girl, 8, is killed and female driver is arrested after Land Rover smashes into hall of £16,000-a-year all-girls Wimbledon school: Police chief chokes back tears after crash that also injured 16 while pupils were enjoying last day of term tea party. ![]() ![]() ![]() ![]() Additionally, adjustable Tone Equalizer allows users to customize the tone of incoming calls to maximize clarity or accommodate for mild to moderate hearing loss. The cordless handsets feature Power Back-Up Operation, a feature exclusive to Panasonic phones, which allows for up to three hours of talk time after the power has been lost.Īll six new phones are equipped with Panasonic's DECT 6.0 PLUS technology which takes the superb sound quality and outstanding range of DECT 6.0 to a new level with an increased frequency of error correction of up to 80 times, improving sound quality and extending transmission range. The new Panasonic KX-TG4770 series is an expandable digital answering system with one corded and additional cordless handsets which features a large LCD screen on the base unit with a simplified button layout for ease of use. ![]() The new KX-TG4753B expandable digital cordless answering system with three handsets includes all the great features of the KX-TG4730 series in addition to a range extender which doubles the effective transmission distance between the base unit and the cordless handsets. Each series is equipped with a side volume key on each handset, similar to cell phones making it easy to users to adjust the volume during a call, and allow for up to 4-way conference calling. The Panasonic KX-TG4740 and KX-TG4730 series are expandable digital cordless answering systems which feature a simplified keypad layout with fewer, larger buttons making it easier to dial. "With the ever-changing landscape of communication tools, our goal is to deliver phones that are easy-to-use and offer unique features that enhance the home communication experience." "Panasonic continuously seeks to provide consumers with innovative telephony products that deliver a superior experience for their communication needs," said Desirae Dolphin, Product Manager, Panasonic Consumer Marketing Company of North America. Additionally, since it is Bluetooth compatible users can transfer up to 3050 entries from a cell phone address book to the handset with the touch of a button. Once paired, cell phone calls will ring on all compatible Panasonic handsets, ensuring that important calls will not be missed. ![]() Simply place the base unit wherever cell reception is strongest and then pair up to two Bluetooth®-enabled cell phones to the system. Link2Cell works with or without landline telephone service. As an added benefit, iPhone users can import their ringtones to the Link2Cell phone system so that each call rings throughout the home with the same tone as the cell phone. The two new Link2Cell® models, the KX-TG7740 and KX-TG7730 series, allow consumers to make and receive cell phone calls on any of the comfortable Panasonic handsets throughout the home. Each of the new 2012 model series are expandable up to 6 handsets, to create a truly robust home communication solution that grows with a user's needs. SECAUCUS, NJ (April 4, 2012) – Panasonic today announced six new DECT 6.0 Plus telephones that offer an array of convenient features for landline phone users including a simplified keypad layout with oversized buttons, large white backlit display, talking caller ID and amplified handsets. New 2012 Lineup includes Two New Link2Cell® Phones Which Integrate with iPhone Ringtones Panasonic Expands Phone Lineup with Convenient Features for Ease-of-Use You'll find the full PR rundown just past the break. Likewise, the 7740 adds a dial pad to the base, and is available with five handsets for $150 (7745S), three for $110 (7743S), two for $90 (7742S) or one for $70 (7741S). The 7730 series ships with three handsets for $100 (TG-7733S), two handsets for $80 (7732S) or a single handset for $60 (7731S). Both models also include the standard gamut of features, including talking caller ID, call block for pre-programed numbers and a handset locator. You can also transfer up to 3,050 address book entries to the household system, while this year's models add an extra layer of iPhone integration, enabling ringtone matching and transfer - you'll now be able to hear that iOS jingle through any connected handset. The KX-TG7740 and KX-TG7730 can both sync up with Bluetooth-enabled phones, letting you make calls through your smartphone as it charges in another room. Two such rigs from Panasonic let you tap your mob for a voice connection, with Link2Cell. Sure, you may have long ditched the landline, but you could still be in the market for a cordless phone. ![]() ![]() ![]() The CSF hypocretin is usually unnecessary and can be used to confirm the diagnosis of narcolepsy but not IH. Usually, the MSLT should have five daytime nap opportunities in IH, and the mean sleep latency is less than 8 minutes with SOREMPs or less than two.Īctigraphy can be helpful as multiple-day recordings occur in a home environment and can corroborate the history with sleep logs- at least over seven days with unrestricted sleep. ![]() Valid MSLT requires that it is performed on the day following nocturnal PSG (with sufficient sleep >6 hours). Other common findings on PSG include a short sleep latency, increased total sleep time (TST), spindles, and increased sleep efficiency. In addition, PSG can help in ruling out sleep-disordered breathing (SDB) and the presence of SOREMs in narcolepsy. However, MSLT is not a sensitive diagnostic test for IH. Therefore, objective tests such as polysomnography (PSG) followed by multiple sleep latency tests (MSLT ) are very important to measure the mean sleep latency and the number of sleep onset REM periods (SOREMs) in addition to the use of a wrist actigraphy in association with a sleep log are essential to distinguish IH from other disorders that cause similar symptoms including depression, insufficient sleep, sedating medication, and sleep-related breathing disorders.Ī total sleep time must be longer than or equal to 66O minutes, especially when the mean sleep latency on the MSLT is longer than 8 min. The diagnosis of IH is by excluding other reasons and causes of hypersomnia. However, history alone is insufficient to make the diagnosis of idiopathic hypersomnia. On polysomnography, they are more likely to have increased slow-wave sleep and present with a longer sleep latency on the multiple sleep latency test. Other symptoms such as automatic behaviors, sleep paralysis, and hypnogogic hallucinations- are common but non-specific.Ĭompared to narcolepsy, individuals with IH were more likely to have prolonged and unrefreshing daytime naps and have a family history of sleepiness. Specifically, individuals with IHwLST can present with a history of severe sleep inertia, fatigue, and evening chronotype tendency. Furthermore, a study of five-hundred sixty-three participants with idiopathic hypersomnia, brain fog, and sleep drunkenness were more common in IH associated with long sleep durations. Īlthough sleepiness is the hallmark of IH, symptoms of this condition are not limited to excessive daytime sleepiness and are frequently persistent despite treatment. Īge at disease onset is usually reported to be younger in the IHwLST group, and MSLT latency is longer, with naps that are non-refreshing. ![]() Individuals with long sleep time (>10 to 11 hours) tend to be younger at the time of disease onset, thinner, and have higher sleep efficiency. Two clinical subtypes of IH have been previously reported as IH with long sleep time (IHwLST, >10 hours) and IH without long sleep time (IHwoLST) in the second edition of ICSD. Patients commonly endorse symptoms of long daytime naps (>1 hour) which are typically non-refreshing but sleep attacks are not frequently reported. The onset of the disease is insidious, with symptoms appearing over weeks to months, making it difficult to elucidate any specific triggering factors. The usual presentation is chronic and disabling excessive daytime sleepiness in an adolescent or young adult, with the majority complaining of "sleep drunkenness" as difficulty waking up from sleep with transient confusion upon awakening. ![]() |
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