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5E: Rules of Exhaustion

Written by Leonardo Andrade

Leonardo is a writer/narrative designer. He spends most of his time crafting stories or immersed in them. Currently, he partakes in several D&D 5E campaigns and likes messing around with other systems such as Heart, Spire and Rats in The Walls. Here's his portfolio.

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D&D night started off tense. The two days’ forced march across the tundra—little sleep in-between—took its toll. Your haggard party trudges through knee-deep snow, eyes fixed on the distant chimney smoke. You need to warn the Ten Towns. The frost giants are coming. How far can you make it before Exhaustion kills you?

Six levels of Exhaustion are all it takes to die in 5E. Each has its own effect, but “a creature suffers the effect of its current level of Exhaustion as well as all lower levels” (PHB, pg 291). Finishing a long rest removes one level of Exhaustion if enough food and drink are had.

Those are the most basic rules, but there’s plenty more to explore. If you’re ready, let’s dive in.

Levels of Exhaustion

The effects of Exhaustion, numbered by level, are: 

  1. Disadvantage on ability checks
  2. Movement speed halved
  3. Disadvantage on attack rolls and saving throws (saves)
  4. Hit Point (HP) maximum is halved
  5. Movement speed reduced to 0
  6. Death

The adventurers from the intro are at 3 of 6 on the Exhaustion scale—one level for each day’s forced march, another for skipping a long rest. All things staying equal, they can do this for another two days and one sleepless night. 

Much could happen on the way, however. There are many ways to suffer Exhaustion in 5E, some to remove or avoid it, fewer to weaponize it

When Do You Take a Level of Exhaustion

There’s a lot of variety in how your character can experience burnout in a game you play to relax. Across the official rulebooks—PHB, Dungeon Master’s Guide (DMG), Xanathar’s Guide to Everything (XGE), Tasha’s Cauldron of Everything (TCE)—they can be grouped into the following categories:

Pushing Past Your Limits

This applies to Exhaustion as a side-effect of overexertion. Here are all the ways you can do it, Rules-as-Written (RAW):

  • Going for more than 24 hours without completing a long rest, you have to succeed on a DC 15 Constitution (CON) save or take a level of Exhaustion. The DC goes up by 5 for every consecutive time you do this in a row (XGE pg 79).
  • Traveling for more than eight hours straight, you have to succeed on a CON save or take a level of Exhaustion for each hour beyond eight. The DC is 10 + 1 for each extra hour. (PHB, pg 181). This also applies to rowing boats (DMG, pg 117).
  • When swimming for longer than one hour—eight for creatures that have a swimming speed—the above rules apply. Swimming for an hour at a depth greater than 200 ft. counts as 4 hours (DMG, pgs 116, 117).
  • When starving—you can live without food for as many days as 3+ your Con modifier (minimum 1). Every day after that, you automatically suffer a level of Exhaustion. Eating normally for a day resets the count but doesn’t get rid of the previously-acquired Exhaustion (PHB, pg 185).
  • You need to drink one gallon of water a day—two in hot weather. If you drink only half as much, you must succeed on a DC 15 CON save or suffer a level of Exhaustion. If you drink less than half the necessary water, you automatically fail the save. If you already have at least one level of Exhaustion (from any source), you take two Exhaustion levels (PHB, pg 185).
  • In a chase, you can freely use the dash action as many times as 3 + your Con modifier. For each additional dash, you have to succeed on a DC 10 Con check at the end of your turn or suffer a level of Exhaustion. You drop out of the chase at 5th level of Exhaustion because your speed drops to 0. You can remove levels of Exhaustion from the chase by finishing a short or long rest (DMG, pg 252).
  • If you’re a berserker barbarian, you can go into a frenzy when raging. You take a level of Exhaustion when your frenzied Rage ends (PHB, pg 49).

Environmental Hazards

This is an umbrella-term encompassing dangers both mundane and extraplanar, as seen in the following list:

  • When in temperatures below 0°F (-17 °C), you must succeed on a DC 10 Con save at the end of each hour or gain one level of Exhaustion. That is, unless you’re immune or resistant to cold damage, or wearing cold-weather gear (DMG, pg 110).
  • You can stay in frigid water for as many minutes as your Con score before you have to succeed on a DC 10 CON save or take a level of Exhaustion. Immunities and resistances from the above apply. (DMG, pg 110)
  • When buried under an avalanche, you suffer 1 level of Exhaustion for every 5 minutes trapped under the snow (TCE, pg 169).
  • In temperatures above 100°F (38°C) without access to drinking water, you must succeed on CON save every hour to avoid taking an Exhaustion level. The DC starts at 5 and increases by 1 for each additional hour. Wearing medium/heavy armor or warm clothing imposes disadvantage on this. You’re safe if you’re immune or resistant to fire damage (DMG, pg 110).
  • Spending time in haunted places, you may find yourself surrounded by supernatural mist. If you start your turn in it, you must succeed on a DC 10 CON save or take a level of Exhaustion. This Exhaustion can’t be removed while you’re in the mist. (96-00 in the D100 Haunted Effects table, TCE, pg 155)
  • Traversing areas taken over by insects, you may have to succeed on a DC 10 CON save or suffer a level of Exhaustion due to the swarming blood-suckers unless you’re immune to disease (96-00 in the D100 Infested Effects table, TCE, pg 157)
  • When taking a long rest in an incompatible plane of existence, you may suffer Psychic Dissonance. You have to succeed on a DC 10 CON save at the end of the rest or take a level of Exhaustion. If your lawful and chaotic alignments are incompatible, this effect is ignored, meaning it doesn’t happen in Mechanus and Limbo (DMG, pg 59).
  • Hearing the Mad Winds of Pandemonium, you must succeed on a DC 10 Wisdom (WIS) save after every hour or take a level of Exhaustion. If you reach 6th level of Exhaustion, you gain a form of indefinite madness instead of dying. You can only remove these Exhaustion levels with a long rest if you escape the maddening winds (DMG, pg 62).
  • When taking a long rest in Hades, you may suffer the Vile Transformation (Optional Rule; DMG, pg 63). You must succeed on a DC 10 WIS save or take one level of Exhaustion that can’t be removed while you’re in Hades. If you reach 6th level Exhaustion, you permanently transform into a larva (DMG, pg 63).
  • When trapped in the Far Realm, you might have to succeed on a DC 10 CON save or suffer a level of Exhaustion (64-72 in the D100 Far Realm Effects table, TCE, pg 152).

Magic Use

This covers Exhaustion as the intended result or as a side effect of magic use:

  • Someone could deny you all the benefits from a long rest by using the Dream spell, which would impose a level of Exhaustion on you.
  • If you start your turn within the area of effect of the Sickening Radiance spell, you must succeed on a CON save (DC depends on the caster) or suffer 4d10 radiant damage and a level of Exhaustion (XGE, pg 164).
  • Immediately after the effect of Tenser’s Transformation ends, you must succeed on a DC 15 CON save or suffer one level of Exhaustion (XGE, pg 168).
  • If you use the Ring of X-Ray Vision more than once between long rests, you must succeed on a DC 15 CON save or take a level of Exhaustion. Same applies for Vecna’s Eye unless you are also attuned to Vecna’s Hand (DMG, pg 224). 
  • If you use the Teeth of Dahlver-Nar (TCE, pg 137):
    • Item 5 on the d20 table, Dooms of Malpheggi: You get a +2 bonus to AC in the form of reptile scales. Additionally, when you finish a long rest, you must succeed on a DC 15 Con save or suffer a level of Exhaustion.
    • Item 13 on the d20 table, Three Bridges to the Sky: You can fly and Detect Magic at will. While you are attuned to less than 3 magic items, you suffer a level of exhaustion that can’t be removed until you are attuned to three or more magic items.
    • Item 19 on the d20 table, Incendax Tooth: you get an ancient red dragon‘s breath weapon, but you suffer two levels of Exhaustion immediately after using it.

Disease

  • If you’re infected with Cackle Fever, you take one level of Exhaustion that can’t be removed until the disease is cured (DMG, pg 257).
  • When afflicted by Sewer Plague, you have to succeed on a DC 11 CON save or suffer one level of Exhaustion. On a successful save, your Exhaustion level decreases by one level, and if it reaches zero this way, you’re cured (DMG, pg 257).

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Misc

  • One effect of eating Primal Fruit on the D8 table (TCE, 169) has you take a level of Exhaustion after experiencing a surge of might. 
  • Poison and “recreational substances” are also conceivable ways to become exhausted, but there’s no RAW for it in the core books. 
  • Suffering Exhaustion due to withdrawal effects from addiction or when crashing after a big boost—like with the primal fruit—isn’t much of a stretch.

One example is soothsalts from the Explorer’s Guide to Wildemount (pg 152). Each dose prompts a DC 15 CON save to resist Exhaustion.

Poisons can be homebrewed to include Exhaustion levels among their effects, too. Considering how powerful such an item would be, the process of making it should be very costly, complicated, and long.

How do I avoid taking Exhaustion in 5E?

Aside from avoiding all the sources of Exhaustion listed in the previous section, there are a few things you can do to avoid taking Exhaustion levels when you otherwise would.

XGE (pg 81) has an optional rule that allows you to maintain the party’s shoes so that you can travel for up to ten hours a day before it’s considered a forced march. 

There is also the magic item, Horseshoes of a Zephyr (DMG, pg 135). “A horse or similar creature” with them affixed to their hooves can move at normal speed for up to 12 hours a day without suffering Exhaustion from a forced march. A Dungeon Master (DM) can allow hooved PCs, such as centaurs and satyrs, to use this item.

Another possibility is commissioning an enchanter to convert this enchantment so that it works on regular shoes.

Being warforged (Eberron: Rising from the Last War, pg 36) can also help. This Player Character (PC) race can complete a long rest in 6 hours instead of 8 and has the Constructed Resilience feature, which gives:

  • Advantage on saves against poison.
  • No need to sleep, eat, drink, or breathe.
  • Immunity to disease.

How to Remove Exhaustion Levels?

You’re already exhausted. Very well. In this case, you need to remove these Exhaustion levels ASAP.

The more mundane way to do it is by completing a long rest while having adequate food and drink. If you use the Tireless (10th level) alternative feature for rangers, you can clear Exhaustion levels with short rests (TCE, pg 56).

The Epic Heroism optional rule uses short rests of just five minutes and long rests of one hour. The Gritty Realism optional rule uses short rests of eight hours and long rests of seven days (DMG, pg 267).

Regardless of how the resting itself works in your game, sleeping in medium/heavy armor can’t remove Exhaustion levels by resting. 

Another way to do it is through magic. Greater Restoration can remove one Exhaustion level per casting. A Potion of Vitality removes all Exhaustion levels in the time it takes to drink it.

How to force Exhaustion Levels on Others?

The most efficient way to weaponize Exhaustion on your enemies is with Sickening Radiance, which I covered above. If you don’t mind having to do it overnight, Dream also does the trick.

Another way is exposing your target to diseases (Cackle Fever, Sewer Plague) or poisons (homebrew) that cause Exhaustion. 

You may also torture them with extreme environmental conditions and forced labor, but this takes a long time, and you might not want to actually become the baddies.

Who is Immune to Taking Exhaustion?

According to Reddit user u/4d6d1, 146 creatures are immune to the Exhausted condition across the Monster Manual, Volo’s Guide to Monsters, Mordenkainen’s Tome of Foes, Guildmaster’s Guide to Ravnica, and Eberron: Rising from The Last War books.

Chiefly among them, from most to least prevalent, are:

  • Undead: 31
  • Constructs: 30
  • Fiends: 21
  • Elementals: 15

If you’re into metagaming, then be aware that these will probably not mind a little Sickening Radiance.

Summary

  • There are six levels of Exhaustion. Their effects are cumulative, and you die on the 6th, save for planar weirdness in places like Hades and Pandemonium.
  • RAW, there are 25 ways to become Exhausted (PHB, DMG, XGE, TCE). They are broadly categorized as overexertion, environmental hazards, disease, and magic effects
  • Drugs and poisons are conceivable ways to cause Exhaustion, but there’s no RAW for this in the core rulebooks. 
  • The only ways to get rid of Exhaustion levels are long rests (short, too, if you’re a ranger with Tireless), Greater Restoration, and Potion of Vitality.
  • The best ways to weaponize Exhaustion are the Sickening Radiance and Dream spells.
  • Avoid Exhaustion for a while by doing diligent shoe maintenance (XGE, pg 81)) or wearing the Horseshoes of a Zephyr (DMG), and be less susceptible to it by being a warforged.

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