All too often, patients who are mechanically ventilated in the ICU find themselves drowning in the abyss of an imperfect, and sometimes iatrogenic, sea of intensive care. We provide therapy, including sedation, with benevolent intent, but harm often follows. We can do better. The Institute of Medicine recommends, amid other sage advice, that care be safe, effective, timely, patient centered, equitable, and efficient. This means the right care in the right way at the right time for the right person, every time for everyone. Individualizing care is critical to this goal, and nowhere more so than in ICU sedation. Whereas benzodiazepines are helpful in managing patients with alcohol withdrawal or status epilepticus, for sedation of the mechanically ventilated patient (the most common indication for benzodiazepine use in the ICU), the evidence clearly shows that the safest and most effective care requires an overhaul of the “sleepy” culture of benzodiazepine sedation in the ICU.