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Rules FAQ How Does Exhaustion Work in D&D 5E?

One handy element of D&D 5th Edition is the concept of conditions. By codifying specific ways that a creature can be hampered, the designers took a significant cognitive load off of designing hazards and debuffs and made the rules more consistent. Most of the conditions are straightforward, with static penalties that apply when a creature is afflicted with the condition (potentially including other conditions) but one stands out as an exception to this general rule: exhaustion, which is unique in that it comes in levels, as we see below.

This is the part of a weekly series of articles by a team of designers answering D&D questions for beginners. Feel free to discuss the article and add your insights or comments!


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Exhaustion
Some special abilities and environmental hazards, such as starvation and the long-term effects of freezing or scorching temperatures, can lead to a special condition called exhaustion. Exhaustion is measured in six levels. An effect can give a creature one or more levels of exhaustion, as specified in the effect's description.

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

If an already exhausted creature suffers another effect that causes exhaustion, its current level of exhaustion increases by the amount specified in the effect's description.

A creature suffers the effect of its current level of exhaustion as well as all lower levels. For example, a creature suffering level 2 exhaustion has its speed halved and has disadvantage on ability checks.

An effect that removes exhaustion reduces its level as specified in the effect's description, with all exhaustion effects ending if a creature's exhaustion level is reduced below 1.

Finishing a long rest reduces a creature's exhaustion level by 1, provided that the creature has also ingested some food and drink.


Gaining Exhaustion in Play
Exhaustion is typically encountered when characters are traveling and/or in a wilderness survival situation.
  • The two most common sources of exhaustion are failing the Constitution saving throws imposed by forced marches or inadequate food and water.
  • Several diseases such as cackle fever and sewer plague can also cause exhaustion.
  • As referenced in the rules entry itself, environmental conditions can also cause it.
  • Occasionally a class ability will also inflict exhaustion.
  • Other sources may exist depending on what supplemental rules are being used.
Managing Exhaustion
Remember, with exhaustion the levels are cumulative. So for example, a character with four levels of exhaustion has their maximum hit points halved, disadvantage on attack rolls and saving throws, their speed halved, and disadvantage on ability checks.

Each time a creature gains a level of exhaustion, they apply the penalties from the new level of exhaustion to those they already have. So in the above example, if the poor character gained another level of exhaustion, their speed would be reduced to zero (half of which is also zero; no need to worry about effects being superceded).

It doesn’t take a rules expert to see that this condition can quickly become debilitating and is best avoided if possible. Exacerbating this, getting rid of exhaustion is not typically something that can be done quickly. In the D&D core rules, there are only few ways, in fact:
  • Resting and the greater restoration spell, each of which only remove one level of exhaustion at a time.
  • Those using the DMG can also benefit from the rare potion of vitality, which removes all exhaustion, poisons, and diseases from a character who drinks it.
  • Being raised from the dead (see below).
In terms of practical advice, one level of exhaustion is fairly manageable, but if a PC acquires a second level, that's a problem worth addressing.

The effects of removing exhaustion work like gaining it, but in reverse, with the highest level of exhaustion removed first and with it, the associated effects. So if the character with four levels of exhaustion above completed a long rest and ate a meal, they would have their hit point maximum restored (and would recover those hit points as part of that rest). If they or another creature then cast greater restoration on them, they would no longer have disadvantage on attack rolls and saving throws.

Nuances of the Exhaustion Rules
You may have heard that characters with six levels of exhaustion can't come back. Is this true? Well, it sort of was, but not any more.

None of the resurrection spells (revivify, raise dead, etc.) specify anything about removing exhaustion, which means that the condition persists on even a dead character. So you could bring a terminally-exhausted character back to life, but then the exhaustion levels would immediately apply and they'd instantly die again. Talk about "dead tired."

Fortunately, WotC fixed this with some errata for the PHB back in 2018. Being raised from the dead now removes a level of exhaustion. So a character that dies from exhaustion is still going to come back with five levels and need a long period of rest (or need five castings of greater restoration, or a potion of vitality) to get back to zero levels of exhaustion.

Other edge cases to keep in mind: a character that goes from four or more levels of exhaustion to three or fewer via a long rest will finish the rest with their full (normal) hit points, but one who sheds their exhaustion via spell or magic item will have their maximum restored to its normal level, but will not automatically recover any missing hit points and will need to get them back some other way.

A creature with three levels of exhaustion has disadvantage on death saves and concentration checks. A creature with even a single level of exhaustion will have disadvantage on initiative (initiative is an ability check, as are all skill checks).

Adding More Nuance to Exhaustion
If you want some more granularity in your exhaustion rules, check out Level Up (Advanced 5e), coming this fall from EN Publishing. Level Up splits exhaustion into fatigue (physical exhaustion) and strife (mental exhaustion), each of which can advance separately, with different effects for each track, and tighter integration into combat and journeys.
 
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Peter N Martin

Peter N Martin

aco175

Legend
This is one of the elements of play that does not come up much at my table. The PCs may gain one, possibly 2 levels from a disease of failed save, but they tend to go away the next day or from the cleric in short order. Most of the campaigns are around the Sword Coast and not in a desert or sailing on the ocean where lack of food and water may cause more of these. Thank you for clarifying a few of the little things about them.
 



CharlesWallace

Explorer
I think it's great that in the image accompanying this article, the knight is so exhausted from that sword plunged into his back. I definitely never considered a sword in the back could cause exhaustion! :p
 

turnip_farmer

Adventurer
For example Xanathar's Guide to Everything introduces a couple of additional sleep rules that affect exhaustion: Sleeping in Armor (page 77) and Going Without a Long Rest (page 78).
Gaining exhaustion due to skipping a long rest is something I just imposed on player's anyway. It's one of those things I don't even consider a house rule; but a straightforward and obvious ruling.
 





Bolares

Hero
I was kind of bummed out by how ToA handled exhaustion. If you didn't eat/drink enough you would gain 1 level of exhaustion in the end of the day, and that would immediatly go away with a long rest... kind of pointless
 

Dragonsbane

Proud Grognard
We used exhaustion for a number of effects since it has 6 levels, and it worked really well!

You gained a level of exhaustion if you went below zero HP, helping to eliminate the up and down with death saves and healing. This needed a long rest to get rid of (or a higher level healing spell like heal or greater restoration IIRC). We also added it for crits, making them hurt a little more and speeding up combats. It helped with how hard it seems to be to get killed in relation to past editions (grognard here).
 

Gadget

Adventurer
It is a shame that the designers didn't find a way to better integrate the exhaustion rules into the rules more smoothly, as it is a great idea. As it is, it rarely comes up unless the DM is running more of a "Fantasy Vietnam" type of game. Also, more rules and spells could have used the system if it was structured a little differently; as it is the benefits of inflicting a level of Exhaustion on a foe are minimal, but can be devastating on PCs. I've seen homebrew "wound levels" trying to use the exhaustion rules, to varying degrees of success. I once heard of a DM that used exhaustion rules with certain undead, to make it more of a fearful experience to encounter them, like in the old days.

It's not like conditions are a new concept, as both 4e and 3e made extensive use of conditions; perhaps too much so as tracking conditions became quite a book keeping chore in some 4e & 3e games. That's probably why 5e made an effort to cut down on conditions and why exhaustion is not more extensively used in the game. I guess the devs wanted it to be a rare and debilitating condition to be avoided. I agree with the post above that I find it incongruent that it is easier to recover from death than a level of exhaustion (at least spell wise, you can't rest yourself back alive).
 

GMMichael

Guide of Modos
How does exhaustion work in 5e?
Typically, players of 3rd edition think there's a rule for everything in 5e and proceed to look them all up. The DM becomes exhausted and wishes he had pitched Fate Accelerated as planned.

This is the part of a weekly series of articles by a team of designers answering D&D questions for beginners. Feel free to discuss the article and add your insights or comments!
Great article, but "...designers took a significant cognitive load off of designing hazards and debuffs and made the rules more consistent..." doesn't read like it's for beginners. Think of the children, man!
 

Superchunk77

Explorer
I was kind of bummed out by how ToA handled exhaustion. If you didn't eat/drink enough you would gain 1 level of exhaustion in the end of the day, and that would immediatly go away with a long rest... kind of pointless
You don't heal exhaustion caused by food/water deprivation unless you eat or drink that day. A long rest does nothing unless you have food/water as well.
 

Stephen Shomo

Explorer
Gaining exhaustion due to skipping a long rest is something I just imposed on player's anyway. It's one of those things I don't even consider a house rule; but a straightforward and obvious ruling.
THIS.

And any other chance I get to hit them with that exhaustion stick... That and getting casting focuses and component pouches off them.
 

phmas

Explorer
At our table, continuously casting cantrips for more than a minute or so would gain you a level of exhaustion.
As would extremely long battles (more than 5 minutes of continuous fighting)
We also use the houserule of gaining an exhaustion level when dropped to 0 HP
 

TerraDave

5ever, or until 2024
We have some house rule examples above, but it definitely seems like more could be done with exhaustion. Of course, most players are probably happy that it doesn't come into play that often.

5E exhaustion has slightly less precedent than attacks of opportunity or concentration. In earlier editions, actual fatigue rules were slight and rarely enforced, unless food was made an issue, or it was a Darksun game. There was also no unified list of conditions, though there where certainly conventions, and these tended to be pretty harsh--like permanent level draining.

3e created a condition list, and more ways of getting harmed than hp--or level--loss. In 3e style, there where over 30 such conditions, and various condition like things that didn't make the list but could still happen to your character.

The designers of 4e played around with a unified health track, to run parallel to hp loss, for poison, disease, getting tired, and so on. This was dropped for a tighter list of conditions, many of which in practice might just last for a few rounds. The condition track ended up as part of the rules for disease, which could get better or worse through time. This was a very interesting system, that probably didn't see much use in practice. (Star Wars Saga edition was developed at the same time as 4e, and does have a condition track).

Given the role of Mike Mearls and other 4e designers in 5e, exhaustion is almost certainly a direct descendent of that proposed 4e condition track (and the SW one). And lingering disease is also still there (and probably still not much used), with links to exhaustion for many diseases.
 

I have completely ignored exhaustion. At some point, I would like to bring it in, but my players still haven't figured out how to use all the different types of action in a fight (rotating group of teens who have never played before). If they ever master that, I will bring in exhaustion.
 


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