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I frequently have trouble sleeping. After a few days of little to no quality sleep, I become unable to fall asleep.
The best way I’ve been able to describe it like a car battery. It helps start the car and when the car drives it keeps the battery charged. But if the battery gets too low it can’t start the car to recharge.
It’s like the part of my brain that tells my body to go into sleep mode hasn’t been charged by getting sleep. I’m so tired I can’t think and I feel absolutely awful, but the sleep doesn’t come.
I have to take a sleep aid when that happens.
This is just anecdotal, but if it works like that for the people who died, it makes sense to me.
That car battery analogy is spot on - neurologically what happens is your brain's sleep regulation system (mainly in the hypothalmus) can actually become dysregulated from extreme sleep deprivation, creating a paradoxical state where you're exhausted but your brain literally can't initiate the sleep process proprely anymore.