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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


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timespike

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).
Yep! That's a pretty popular one.
That gives players exhaustion as well
It's funny because it's true!

"What're we doing this week?"
"We're picking our combat from the last 4 sessions up on round 347."
 

phmas

Explorer
Wait... your PCs are involved in combats that last 30 rounds or longer?
Yeah, sometimes, depending on the story. I usually run my dungeons very dynamically, so it's not that uncommon that a group of organized bad guys just go wave after wave against my players. Like a time they tried to infiltrate a keep, but unfortunately sounded every alarm. That was about 60-70 rounds of battle
 


Superfreak666

Villager
Redcap, my gnome barbarian, wishes there were more ways to use healing to cure exhaustion than just taking a long rest. Frenzy is a great class ability, but using it more than once per day is pretty debilitating, and it can be hard to assess which combat warrants using Frenzy versus was a waste because combat lasted 2-3 rounds . . .. Why not allow some of the healing spells to remove a level of exhaustion, perhaps if cast at a certain level spell slot for some spells, in lieu of HP at the option of the caster?
 

Morley_Dotes

Villager
Redcap, my gnome barbarian, wishes there were more ways to use healing to cure exhaustion than just taking a long rest. Frenzy is a great class ability, but using it more than once per day is pretty debilitating, and it can be hard to assess which combat warrants using Frenzy versus was a waste because combat lasted 2-3 rounds . . .. Why not allow some of the healing spells to remove a level of exhaustion, perhaps if cast at a certain level spell slot for some spells, in lieu of HP at the option of the caster?
There is an old 1st edition spell called Dispel Exhaustion. It was in the Illusionist spell list. You could modify it for 5e.
 

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