Insanity

[Homicide13]

Insanity also makes you less reliable, which mechanically means you trigger more scary scripts and monsters can hear your raspy gasps for air and find you much easier.

If you want to be the safest you could, you would never use the lantern, progress slowly and in the dark, retreat to a predetermined small room with hiding location at the first sign of anything, and huddle under a light in those safe rooms until your mind is clear before moving to the next position. It makes a slow game even slower, but the mood can really sink into your bones that way, too.

How would you define "less reliable"? So panting from insanity does catch the monster's attention in the same way being in the light does?
And there are certain scripts that will trigger (ie spawn monsters) once your insanity has reached a certain level?