Last time I fucked up my sleep schedule and was a zombie for the second day. I learnt a lesson - all-nighters are for the second day only (which should have been obvious, seeing there's no advantage to an all-nighter on the first day anyway).
I still have no confidence that I can make a game in 48 hours though. What other people manage to do in that timeframe amazes me, and I'm not sure how they do it.
I'm absolutely amazed by some people, too, but what they're doing comes from tons of practice, and not some magic incantation.
I failed my first and third LDs, but I managed to enter on my 2nd and 4th. The keys are:
Know your tools. You don't have time to learn.
Stick to things you know. You don't have time to learn.
Keep it simple. You can create interesting interactions with very simple mechanics. Unity's way of using components helps a lot with this since you can keep features separate and re-use them. For instance, if your enemy movement, weapon and ammo scripts are separate, you can end up with walking, swimming and flying for movement, crossbows and longbows for weapons, and normal, flaming and life-stealing arrows for ammo. That's 18 different enemies from 8 scripts. As you add more scripts, you multiple instead of add.
Know your scope. Knowing how much of each task you can accomplish in a few hours will help you determine the scope of the game. For instance, I have *no* clue how long level building takes for a proper pixelated 2d platformer because I've never done it. It would be crazy for me to plan one as I'd most assuredly run out of time. Instead, I made the levels out of 3D blocks and gave them some color, then made a few levels from that.
You don't have time to decide, except at the beginning. Spending an hour or 2 picking your idea is normal, and lets you think it through. After that, you have to just go go go. If something seems like a good idea and will be easy/quick to implement, just do it! Don't bother wondering how to do it best or most efficient. You don't have time for that.
And finally, failing a few times is normal. It's better to have tried and failed than never to have tried at all. I learned a *lot* from that first failure of mine, and I used that information to prepare myself for the second one. But if I hadn't tried (because I knew I wasn't ready) I wouldn't have learned anything from it.