iserith
Magic Wordsmith
In my games, you can't cast spells with a V component underwater unless you can breathe water.
In D&D 4e, there were a couple notable rules that made things interesting. First, many creatures had an Aquatic trait, which basically meant that it had combat advantage against creatures that didn't have the Aquatic trait (if I remember correctly). You could make this a trait in a D&D 5e monster's stat block easily enough: "While swimming, the [monster] has advantage on attack rolls against creatures in the water that do not have a swim speed."
As well, in D&D 4e, if holding one's breath in combat, the player had to make a DC 20 Endurance check at the end of the character's turn in which the character takes damage. Failing the check meant losing a healing surge and had to make subsequent checks each round at +5 DC each. If the check was failed and the character has no healing surges left, the character takes damage equal to his or her level, even after being reduced to 0 hit points (until death).
This latter rule's a bit fiddly by D&D 5e standards in my view, but it seems like something easy enough to adapt. Maybe something like damage forces a Constitution check with failure reducing the time the character can hold its breath by 1 minute.
In D&D 4e, there were a couple notable rules that made things interesting. First, many creatures had an Aquatic trait, which basically meant that it had combat advantage against creatures that didn't have the Aquatic trait (if I remember correctly). You could make this a trait in a D&D 5e monster's stat block easily enough: "While swimming, the [monster] has advantage on attack rolls against creatures in the water that do not have a swim speed."
As well, in D&D 4e, if holding one's breath in combat, the player had to make a DC 20 Endurance check at the end of the character's turn in which the character takes damage. Failing the check meant losing a healing surge and had to make subsequent checks each round at +5 DC each. If the check was failed and the character has no healing surges left, the character takes damage equal to his or her level, even after being reduced to 0 hit points (until death).
This latter rule's a bit fiddly by D&D 5e standards in my view, but it seems like something easy enough to adapt. Maybe something like damage forces a Constitution check with failure reducing the time the character can hold its breath by 1 minute.