When the new operating system “Windows 10” was released, reviewer Walt Mossberg commented that “Microsoft takes a step back to move forward.”1 In this same regard, forward progress of sedation for gastrointestinal (GI) endoscopy requires taking a step back. From the findings of Wernli et al,2 the role of propofol and its administration during colonoscopy has come under debate. The philosophy, “you will sleep fantastically and wake up,” needs to be reexamined.