Sedation is a significant component in the comprehensive treatment of a critically ill patient. The presence of anxiety and pain can often be left unexpressed, particularly in patients on mechanical ventilation. Opioids are primarily used for the treatment of acute pain and sedative agents (i.e. benzodiazepines, propofol) are used to achieve sedation. Sedation is required in mechanically ventilated patients, yet the optimal strategy for its management is unclear. Daily interruptions of continuous intravenous (IV) sedation (i.e. sedation holiday) have shown to result in a shorter duration of time on mechanical ventilation and intensive care unit (ICU) stay. However, sedative agents have the potential to accumulate despite daily interruptions, leading to drug redistribution from the tissues into the circulation. This may delay mental status recovery and cause abrupt agitation despite decreased or discontinued sedatives. Therefore, daily sedation holidays do not always result in awakened and communicative patients. Optimal management for sedation is necessary to avoid accumulation of drug and prevent sedation-induced delirium.