It sounds like the brain is running something like a defragmentation routine every night. If it doesn't complete, your thoughts become more and more incoherent.
I've got no clue how people stay awake for more than 48h; just last week I fell asleep in front of the computer after being awake for 24h. For me, it requires mental gymnastics to be able to go beyond that.
Sleep Lets Brain File Memories
http://www.scientificamerican.com/article/sleep-lets-brain-f...