D&D General Exhaustion levels before death saves

Li Shenron · 2026-04-18T09:20:07+0100

After elaborating the responses in my other thread about popular death & dying house rules, I am now brainstorming some house rule options for yet another one-shot game where I'll have several beginner players at the table.

They'll be 1st level and won't have time to level up, so I don't care how the house rule keeps up at higher levels.

I am a bit tired of CR1 and lesser monsters so I'll be using some CR2 and possibly a CR3 as the final boss, perhaps a wyrmling or a spectator to give them a truly D&D iconic creature to face, even if it will be their lowest-CR version. This of course means a high risk of taking down a 1st level PC with a lucky roll, due to low HP.

I might still consider having them start at level 2, though not ideal, or levelling up in the middle. Not higher than that to keep characters simple enough to play. They'll be using pre-gens so I have control over the complexity.

So assuming 1st level for now, I am thinking of a house rule that would both lower the chances of dying and keep the PC fighting for longer. Normally in my games I use the dying rules as-is, but if someone really dies I offer them the chance to trade death for a temporary (but not too short-term) penalty. This time I will try something different...

Exhaustion levels seem to be a popular idea to tie-in with dying rules. So my starting point for a house rules is this:

death from massive damage is ignored
at zero HP, the PC gains an exhaustion level
every time the PC suffers damage, they gain an additional exhaustion level (2 for critical hits)
if they reach the last exhaustion level, instead of dying they fall unconscious and start making death saves normally

This creates quite a buffer before dying, no less than suffering 3 additional attacks. Ignoring massive damage + gaining exhaustion not being tied to the damage amount means to lower the main risk of CR monsters (they still have a big chance of dropping to zero, but not to die).

I don't expect any PC to drop to zero in the first half of the session, and if they do there'll be a long rest to reset a level of exhaustion (or even handwave more if necessary). Probably the house rule will only really kick in during the final boss fight. Yes, there will be a death spiral at that point, but it should still be better than PC dropping unconscious for defeating the final boss, and the remaining exhaustion levels will be irrelevant.

MarkB · 2026-04-18T12:22:01+0100

For this scenario I don't see how having players come to grips with custom death and dying rules and then cope with applying penalties to their rolls is significantly less of a learning curve than just starting them at level 2.

Li Shenron · 2026-04-18T13:00:44+0100

MarkB said:
For this scenario I don't see how having players come to grips with custom death and dying rules and then cope with applying penalties to their rolls is significantly less of a learning curve than just starting them at level 2.

You don't see it?

Level 2 implies more abilities to choose from during gameplay, entirely in the player's hands. More choices means more complexity.

Dying house rules, they don't even need to know they exist until one of them drop to zero hp. Even then, I will be there to tell them where to roll with disadvantage or how their movement is limited.

That said, I haven't ruled out completely about level 2. Since they'll be using pre-gens, I can easily keep the complexity down, and in general it's still not high at all at level 2. Having them all human already about halves the complexity. It just doesn't feel fully satisfying to have beginners not start at level 1.

I might wait until halfway through the session, see how they're doing with managing their character's abilities, and then decide to either level them up (if it seems they can handle more complexity) or stay at level 1 and use these house rules to protect them from dying.

aco175 · 2026-04-18T13:09:16+0100

I might group them so when you are dying you gain level 1 and 2 but can still do something. Then level 3&4 if you are not healed or stabilized, but you can still do something. Then level 5 with a dramatic roleplay to show the others that I need healing, but you can still do something. Then you die, sorry, great job. I would still let them roll a death save to stay at the same level or gain more levels.

You can also just give everyone a potion of healing to start off.

DEFCON 1 · 2026-04-18T13:39:41+0100

This is a lot like how I do my death and dying rules for my normal games, as I also use the 6-level Exhaustion chart in place of the 3 Death Saves chart. Thus as you mentioned, when one reaches 0 HP they gain Level 1 Exhaustion. Every additional hit they take gives them another level, crit hits give them 2 levels, and they also still roll death saves on their turn to gain levels as well (since I don't tend to have enemies attack downed PCs, and thus they would usually never gain additional levels if I didn't have them roll death saves.) Like in normal death saves, a Nat 1 has them gain 2 Exhaustion levels, a Nat 20 stabilizes them, three rolled successful death saves also stabilizes them, and another PC can use an action to make a DC 10 Medicine check to stabilize the PC as well.

The other thing I've done is re-order the Exhaustion chart, as I have found Disadvantage on Ability Checks at Level 1 to be the least fun option for players to have to deal with, because it's the only one that really sucks after the combat is over. All the other penalties are combat-related... they only really impact you while fighting... and that can be ameliorated by just not getting into additional combats the rest of the day. But for Disadvantage on Ability Checks... to have every single other thing the PC will do throughout the rest of the day be at a disadvantage makes the rest of the game for that player really crappy until they can finally rest (IF they can finally rest). So my chart is as follows:

Level 1 - Speed halved
Level 2 - Hit point maximum halved
Level 3 - Disadvantage on attack rolls and saving throws
Level 4 - Disadvantage on ability checks
Level 5 - Speed reduced to 0
Level 6 - Death

Of course, you might be using the 5E24 Exhaustion rules, and thus your chart is a little bit different. I've never used the '-2 x Exhaustion level' penalty to d20 tests that the new rules use, so that might not be as painful as the original Exhaustion chart (or for all I know, it could be worse.) So best of luck with whatever you end up going with!

CreamCloud0 · 2026-04-18T13:49:13+0100

Li Shenron said:
Exhaustion levels seem to be a popular idea to tie-in with dying rules.

True it’s a popular idea, but for as long as people have been associating the two they’ve also been realising it’s a terrible idea to do so, It just causes death spirals.

Just do something simple like doing the three basic death saves but they pop up with 1HP at the start of the round on a single success

Additionally, you could just start them all off with an additional full hit die of HP.

Li Shenron · 2026-04-18T13:54:06+0100

aco175 said:
View attachment 434927

I might group them so when you are dying you gain level 1 and 2 but can still do something.

Yeah grouping sounds like a good idea, as maybe 5 levels might be unnecessarily too big of a buffer. Also level 1 hardly matters before combat is over (and then it becomes the worst), and level 4 is practically irrelevant if I ignore death from massive damage.

Li Shenron · 2026-04-18T14:03:24+0100

DEFCON 1 said:
The other thing I've done is re-order the Exhaustion chart, as I have found Disadvantage on Ability Checks at Level 1 to be the least fun option for players to have to deal with, because it's the only one that really sucks after the combat is over.

I agree completely. I was never a fan of the exact effects of exhaustion in 2014, but I am even less happy with the unimaginative 2024 version.

I thought briefly about making my own exhaustion effects, and for the players it won't matter anyway, then I just decided to keep it simple here and use defaults but I can always go back to the drawing board. A couple of ideas I briefly entertained myself with for alternative effects were (a) roll a d6 to select a random ability and get disadvantage on all its related rolls, or (b) roll randomly an affected body part or function (such as vision, leg movements, arms movements, thought...) and then figure out reasonable penalties.

Li Shenron · 2026-04-18T14:10:22+0100

CreamCloud0 said:
True it’s a popular idea, but for as long as people have been associating the two they’ve also been realising it’s a terrible idea to do so, It just causes death spirals.

It's because as far as I remember nobody proposes this before death saving throws, but rather as a replacement for being unconscious. Here even a death spiral adds a buffer.

In addition, the general discussions are pretty much always assuming the game continues. I will use these in a one-shot, specifically for the purposes of using a bit higher CR monsters and wanting the PCs to keep fighting longer, and not die anyway (most likely in the last combat encounter). Even with penalties, the output of their economy of actions will be better than falling unconscious immediately.

MarkB · 2026-04-18T14:43:41+0100

Li Shenron said:
It's because as far as I remember nobody proposes this before death saving throws, but rather as a replacement for being unconscious. Here even a death spiral adds a buffer.

In addition, the general discussions are pretty much always assuming the game continues. I will use these in a one-shot, specifically for the purposes of using a bit higher CR monsters and wanting the PCs to keep fighting longer, and not die anyway (most likely in the last combat encounter). Even with penalties, the output of their economy of actions will be better than falling unconscious immediately.

As I haven't read the previous thread you mentioned, can you clarify what "before death saves" actually means in this context? I was picturing the character still going unconscious, but accumulating exhaustion levels instead of death save fails each round. Is it instead that they remain conscious at 0 hp but gain a level of exhaustion, and subsequent levels for additional hits?

It still seems overly complicated as a solution to using higher levels monsters as compared to starting at higher levels. And just giving the characters more hit points would seem to be a better compromise than adding this mechanic for the players to deal with, that they're never going to see again in regular games.