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Let's say i'm a typical paranormal zoanthrope who spends his weekends fighting with or against lovecraftians inside a gargantuan stomach thrice the size of Earth. I keep my arsenal of flesh-eating balloons, polymorphing spiked ladder, flaming chalice, rotting barghest husk, etc etc in check. But most importantly, i've got my zoanthropic constitution. Because part of my constitution lets me do stuff like regenerating quickly, i've found that i can keep murdering thousands more of them misshappen buggers for days and days on end, and i still wouldn't feel drowsy. No, i'm not in constant fear, either. At best i can only sleep forcibly for around an hour, and that's it, i have to wait until i'm REALLY sleepy.

So, that aside, what do you think would be a suitable medical explanation for this?

Freaking Sweet. lol

I can think of two possibilities.

1) Your body is producing its own energy.
I toyed around with this briefly in my writing, briefly suggesting that lycanthropy can convert energy out of something the body produces naturally like Vitamin E (which might explain why werewolves often look like pasty goth depressants). That would have meant describing werewolves as photogenic, so I dropped that one as quickly as I came up with it.

2) Your zoanthropy is giving you a contact high.
You might not be physically drained, but that doesn't say anything for your emotional and/or mental wellbeing. If you did have boundless energy, you'd either abruptly crash, peak and OD, or run out of lovecraftians to battle and be stuck alone with a perpetual bloodlust after God only knows how many years of never-ending combat it would take to kill them all.

Never-ending battle? The way you described it reminded me a lot of the description I read of Acheron from the Forgotten Realms setting. Acheron is the eternal battlefield: endless fighting until you completely lose yourself in it. That's what would eventually happen: You'd get stuck with that battle high and not be able to come down off of it.

You are infused with the godlike vigor of whichever supernatural patron deity bestows such mysticism as zoanthropy, and like Heracles, you can perform dauntless tasks of endurance far beyond the capacity of a mere human.

No medical explanation needed!

Uhhh; if you are in biovital balance, you never run down. You never get tired. You don't need to sleep, other than to dream um more madness.

If E out =E produced ^ no rest needed.

Like a jellyfish....