For more than a decade, ICU clinicians have studied the effects of sedation on the comfort and outcomes of their patients.1 Yet, even during clinical trials that closely implement protocol-driven sedation, 32% of patients were minimally- or non-arousable, but only 2.6% of these patients were given an oversedation rating.([FOOTNOTE=Weinert CR, Calvin AD. Epidemiology of sedation and sedation adequacy for mechanically ventilated patients in a medical and surgical intensive care unit. Crit Care Med. 2007;35(2):393-401.],[ANCHOR=],[LINK=]) What might this rate discrepancy be in the absence of protocol-driven sedation? And how can clinicians improve care?