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What science has discovered through observation is that if you don't sleep you seriously start sucking at everything. There are a few cases of people who never sleep or almost never sleep, but they are exceptions - the rest of us needs to get our Z's in regularly to operate.
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We don't really know whether he sleeps. He might have stage 1/2 sleep.
When you awake from stage 1/2 sleep you think you haven't sleept.
It would be interesting is someone would study him.
Modafin allows you to be 3 days awake and sleep afterwards a normal night. One forum member (if you use the forum search you might find the post) told that someone he knew got pretty screwed up from multiple years of Modafin use. Use it on a permanent basis is probably not healty.
Normally people don't feel sad when they are sleep deprivied. In general they rather feel happy. Sleep deprivation is considered as a short term solution against depression.