I couldn't agree more with DHH here. Although addiction to "work's highs" is one explanation, I think its often simply a noble-sounding excuse to not expend the effort to exercise regularly or maintain a significant other. Hacking is fun, working out and maintaining relationships are hard. I fell into this trap when I was an undergraduate, sleeping 4 hours a night and putting on a significant amount of weight. After I finally got my priorities straight a few years ago, I lost the weight, started sleeping 8 hours a night, and my quality of life has improved dramatically.

There are always going to be periodic crunch times when you need to pull out all the stops to hit a deadline. However, if this is the norm rather than the exception, I think you're doing it wrong. Note that I still agree that you shouldn't be expecting to take vacations and enjoy lazy weekends, its just that 8 hours of sleep a night and regular exercise should be non-negotiable.