I suspect there are some mental problems pushing him this hard. I highly doubt that it is efficient to work that long weeks unless Elon Musk is made of entirely different substance than the rest of us.
I have read about highly successful scientists such as Charles Darwin and their work schedule. He put in a lot of rest. He would take long walks, eat properly, make sure he had some variation.
I believe they measured productivity of scientists working different hours and found that those working 4 hours actually were the most productive.
It didn't mean necessarily 4 hours straight but four ours with proper breaks, lunch etc. Maybe a walk. Time to calm down and think about stuff.
I think the study said that you could beat these guys by working insane hours but only by a small margin. Hence Elon Musk may be burning the light at both ends without necessarily getting the results he could have gotten.
I think a lot of people mistankenly think all his results are from working really hard, when reality is that it is mostly because he is way smarter than most of us.
I hope Elon Musk gets sensible about this otherwise he will burn out and crash. I knew a guy who worked like Elon Musk. When I met him he basically lived like a Munk and could hardly work. His life was basically ruined.