I believe some years back the U.S. Department of Defense oversaw flight simulation studies on military pilots in which a control group was compared with a group that had blood-alcohol levels above the legal limit for operating a vehicle, and a third group that had twenty-four (or more) hours without sleep. Results indicated sleep deprivation proved even more detrimental in the simulators than baseline legal intoxication (.08 blood-alcohol content in many parts of the United States).
Which is not an argument for operating vehicles under the influence of alcohol. However, it does suggest that sleep-deprivation is very bad for things like decision-making, dexterity precision, reaction time, and so forth. In addition, there are a growing number of studies examining the effects of sleep deprivation among medical residents assigned to 24- or 36-hour shifts on ward, and the results aren't good.
Which is the long way around to say that, in addition to the saving throws, you might also consider sleep-deprivation effects expressed as things like penalties to dexterity-based activity, reductions on intelligence-based and wisdom-based checks, and similar, as well as eventual h.p. damage at some point. Sleep deprivation is bad. There's a reason our brains need rest cycles.
Still learning,
Robert