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I sometimes get bouts of insomnia. Usually when it happens, I'm just awake for about 30 hours or so. That'll happen once or twice a month for me, and I'm pretty sure is just stress-related.
The longest I've gone was 75 hours when I was in my early 20s, which was due to a really bad allergic reaction to cedar pollen which kept me from breathing while laying my head down in any position, so I couldn't fall asleep no matter how hard I tried. I was also running a pretty high fever while this happened. I probably drifted into microsleeps while sitting up a few times during that, but it was absolutely miserable.
I started having really bizarre auditory hallucinations after about the 40-hour mark. I'd hear a crowd of people laughing from behind the walls. Not like a malicious laugh, but like there was a stand-up routine happening in the next room over. Nobody else was home, no TVs were on, and it was like 3am so I knew what I was hearing wasn't real, but convincing myself of that didn't make the laughter stop.
I think I slept for about 13 hours straight after that.
There were a few times I was staying up late to play WoW and the computer fan would start talking. Not saying any words, but like listening to the Sims talk.