There's no pathology, it's just really really hard. Any single component not sleeping properly and keeping the CPU, buses or radios active immediately ruins the battery life for everyone.
Power saving is all about racing towards that sweet idle state where every chip is clocked down and nothing radiates.
Which means that good power saving requires full vetting of every process on the system and making sure they all cooperate or, at least, are forced to sleep.
Android needed years to get into that state and developers/hackers are still sour about the restrictions it puts on them to keep battery life in check.