Abstract Introduction Orders such as vital signs (VS) and neurological checks (NC) contain frequency options to help clinicians align workflows with patient needs. However, these clinical decision support (CDS) systems often default to around-the-clock, and clinicians may over-accept around-the-clock, leading to unnecessary sleep disruptions. Methods We added two radio buttons to VS/NC orders: q4 hour while awake (q4WA) and TID while awake (TIDWA). We gave presentations on CDS to inpatient neurology unit (INU) residents and staff pre-intervention. We sent reminders to INU residents to review and modify (when appropriate) around-the-clock orders via secure chat. We defined the pre-intervention period as six months before and the post-intervention period as six months following. Order frequencies and NC/VS performed from 11 pm–7 am were obtained via EHR. Pre- and post-intervention data were analyzed using interrupted time-series analysis (ITSA). Results Post-intervention, there was a significant decrease in q4 order frequencies (VS 15% and NC 17%,p< 0.001) across the institution. Subgroup analysis of the INU revealed more significant reductions in q4 frequencies (VS 54% and NC 48%, p< 0.001). Sleep-friendly orders significantly increased for VS and NC (0% to 6.7%, 0% to 7.8%). Sub-group analysis of the INU was again more profound, with sleep-friendly orders increasing from 0% to 16% for both VS and NC. Additionally, overnight VS and NC performed decreased by 11% and 17% post-intervention (p< 0.001) at the institution, with a further reduction in the INU (45% and 35% decrease for VS and NC, p< 0.001). The case-mix index was appropriately lower in the population with while awake orders (1.2749) versus around-the-clock orders (2.2684) Conclusion CDS modifications significantly increased sleep-friendly orders while reducing around-the-clock order frequencies and NC/VS completed overnight. These results were more profound on the INU, indicating that a combination of CDS changes, education, and chat reminders demonstrated a higher impact than CDS changes alone. Support (if any)