What does insanity even do?

[Tekker]

I know how to reduce it but does it going to high even effect anything?

[Darx]

normally it increases the chance for your character to become confused, insane,... and such status effects

[Kelven]

From what I read on the Elin discord, it apparently is just a sleep indicator. At 40 insanity you get "Sleepy", and 60 insanity you get "Very Sleepy".

Whether there's more to this mechanic or not, I have no idea. To decrease insanity, all you need to do is sleep.

Originally posted by Darx:

normally it increases the chance for your character to become confused, insane,... and such status effects

That makes sense

[AvG]

At max insanity the game warns you that if you stay insane too long you can just flat out die. I have not tested this but yes you can get random debuffs like confusion.