I also suffer from insomnia - I regularly get 3 hours of sleep per night, and rarely get more than 6 (rarely as in 1-2 times per month). For a week and a half or so, though, after a death in the family, I was getting between 0 and a half hour per night, with obviously no deep sleep.
I developed severe ataxia (I couldn’t walk without a cane), I lost the ability to speak coherently and it would take me minutes to form a sentence. I couldn’t follow conversations, and my appetite decreased to the point where I was down to about 50-100 calories per day (eg, I could sometimes manage a can of coke).
When your brain starts to shut down, things really go south pretty fast. I managed to kickstart things using those meal substitute drinks (which I’d consume by chugging it in one go), and eventually my eating and normal 3-6 hour sleep pattern came back, but I was probably about 24-48 hours away from needing an ambulance.
Luckily I live with my partner and although I put them into a panic, I didn’t have to manage the house/pets and just took sick leave from work. Even after going back, it took some time to return to my normal level of working. At the peak, I would have been absolutely incapable of operating if I lived alone.
When my insomnia hits it’s days of zero sleep… Like I see the 3 hours of sleep and I immediately (and unfairly) dismiss that you have insomnia, I’m just like, “bro, but you ARE getting sleep”).
As I got my things under control I pivoted to Polyphasic sleep anyway. 1 30min nap every 6hrs and I absolutely adore it. Extra exertion or any kind of injury will warrant more rest, but then, thats resting with a purpose.