Answer 1 is incorrect. 25% chose this answer, “Refer to a sleep study to evaluate for obstructive sleep apnea and adjust the medication regimen.” While a sleep study may be recommended for suspected sleep disorders, such as sleep apnea (for example: loud snoring, daytime sleepiness), the first step should be a comprehensive sleep health screening. This screening helps identify potential causes of poor sleep, including symptoms of sleep disorders, disruptions from diabetes management (for example: nocturnal hypoglycemia, frequent urination), or anxiety about sleep. Based on the findings, appropriate treatment modifications and referrals can then be made.

Answer 2 is incorrect. 1% of you chose this answer, “Encourage engagement in vigorous evening exercise to promote better sleep.” Although exercise can improve sleep quality, vigorous evening exercise may increase alertness, making it harder to fall asleep. In individuals with type 1 diabetes, this timing of exercise can also increase the risk of nighttime hypoglycemia, further disrupting sleep. Before recommending vigorous exercise, it’s important to first assess sleep habits to better understand the underlying causes of poor sleep quality.

Answer 3 is correct. About 71% of respondents chose the BEST ANSWER – GREAT JOB! “Screen sleep health and develop a plan to create consistent sleep routines and habits.” The 2025 ADA Standards emphasize the importance of screening for sleep health and providing guidance on sleep-promoting routines and habits. Based on screening results, referrals to sleep medicine programs, adjustment in medications or behavioral therapy programs are a few that may be appropriate. Prioritizing improved sleep duration and consistency can support better glucose management, reduce fatigue, and enhance overall well-being.

Finally, Answer 4 is incorrect. 1% chose this answer, “Advise taking over-the-counter melatonin supplements to improve sleep quality.” While melatonin may be helpful for certain sleep disorders, its use should be evaluated on a case-by-case basis and is not recommended within the ADA 2025 Standards of Care. The first-line recommendation should focus on screening to better determine appropriate actions.

We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!