How accurate is Sleep() or sleep()
I'm trying simulate a key down and key up action.
For example: 2638 millseconds.
SendMessage(hWnd, WM_KEYDOWN, keyCode, 0);
Sleep(2638);
SendMessage(hWnd, WM_KEYUP, keyCode, 0);
How would you know if it really worked?
Answer
You wouldn't with this code, since accurately measuring the time that code takes to execute is a difficult task.
To get to the question posed by your question title (you should really ask one question at a time...) the accuracy of said functions is dictated by the operating system. On Linux, the system clock granularity is 10ms, so timed process suspension via nanosleep() is only guaranteed to be accurate to 10ms, and even then it's not guaranteed to sleep for exactly the time you specify. (See below.)
On Windows, the clock granularity can be changed to accommodate power management needs (e.g. decrease the granularity to conserve battery power). See MSDN's documentation on the Sleep function.
Note that with Sleep()/nanosleep(), the OS only guarantees that the process suspension will last for at least as long as you specify. The execution of other processes can always delay resumption of your process.
Therefore, the key-up event sent by your code above will be sent at least 2.638 seconds later than the key-down event, and not a millisecond sooner. But it would be possible for the event to be sent 2.7, 2.8, or even 3 seconds later. (Or much later if a realtime process grabbed hold of the CPU and didn't relinquish control for some time.)