Exhaustion is a condition in Dungeons & Dragons 5e that simulates the effects of extreme tiredness, freezing cold or anything else that can sufficiently wear down a character to the point where their physical and mental abilities are diminished. If taken too far, exhaustion can even be fatal.
If you’re a new Dungeon Master or a new player (or even if you’ve been playing the game for a while) and exhaustion is new to you, you’re not alone. It’s a remarkably underutilized rule in D&D 5e and often gets hand-waved – or forgotten – at the table.
I think this is a shame, however, as exhaustion is a useful tool for adding realism to a game of D&D, not to mention a powerful weapon in the hands of a DM (or player) who knows how to use it.
How does Exhaustion work in D&D 5e?
The rules for exhaustion can be found in Appendix A of the Player’s Handbook, alongside other conditions like frightened, petrified, and incapacitated.
A creature can suffer exhaustion as the result of starvation, freezing or scorching temperatures, and other environmental hazards, as well as “some special abilities”.
If a character goes for too long without sleep or food, climbs a frozen mountain without proper equipment, or tries to cross an endless desert without enough water, they’re going to start accruing exhaustion.
While it’s not explicitly stated in the RAW, most DMs give their players the chance to make a Constitution saving throw to avoid suffering a level of exhaustion.
This is backed up by the fact that the only spell that can impose exhaustion, Sickening Aura, allows those affected to make a Constitution saving throw to avoid its effects.
Exhaustion is divided into six levels, and certain effects can apply one or more levels of exhaustion at a time.
Each level of exhaustion compounds with the effects imposed by the previous levels, stacking their effects in a way that can start to feel really detrimental, really fast.
1 Disadvantage on ability checks
2 Speed halved
3 Disadvantage on attack rolls and saving throws
4 Hit point maximum halved
5 Speed reduced to 0
Roll with disadvantage on all ability checks. We’ve all been here: trying to remember the answers to a test after a night of broken sleep, or trying to do something as simple as unlocking a door when you’re so tired you can barely remember your own name.
The first level of exhaustion is unquestionably nasty; you become noticeably less effective at actively doing things. However, when the chips are down and the adrenaline kicks in, you can still function as normal when making attacks and saving throws.
Your movement speed is halved. Your feet drag on the ground and your movements seem sluggish. Things are starting to get inconvenient, especially if you’re in combat against a highly mobile opponent.
You now roll with disadvantage on all attack rolls and saving throws. This is where things get really nasty. Disadvantage on saves and attack rolls – combined with disadvantage on checks from Level 1 – means you’re perpetually less likely to succeed at just about anything, including Constitution saving throws to avoid suffering more levels of exhaustion. And that puts us in death spiral territory.
Your max hit points are halved. You’re physically wasting away, as a result of sleep deprivation, dehydration, painful gnawing hunger, or the continued effect of your environment.
I’m sure if you’ve ever been tired enough that you feel physically sick and, medically speaking, there’s a direct correlation between fatigue and diminished muscular strength. Mechanically, you’re much easier to one-shot kill.
Your speed is reduced to 0. You can no longer move. You could still stand with great effort, but taking even one more step is out of the question. You’re more or less helpless. If you wish to continue, you’ll have to be carried.
You die. No death saving throws, no prolonged unconsciousness. Your body and mind give up on you in the face of extreme fatigue or deprivation and you are gone forever.
What can trigger exhaustion?
While there are some special abilities, circumstances, and exactly one spell in the official rules that can cause exhaustion, much of the time, exactly when, where, and how exhaustion is triggered is left up to the DM.
As with many of D&D’s less widely-used rules (who am I kidding? This applies to pretty much every rule) each DM probably has a different set of conditions that they use to trigger exhaustion.
How and when exhaustion is triggered – or whether you bother to use it at all – can do a lot of work when it comes to setting the tone of your campaign.
Want to run a high-fantasy game in a world where food is in plentiful supply? You’re probably not going to use exhaustion that often.
Want to run a dark fantasy game in which your players are going to have to fight tooth and nail for every scrap of good fortune that comes their way? Exhaustion is going to be the sword you hold over their heads from level one to twenty.
Thinking about those extremes, as well as possible games in between, let’s look at some of the metrics that determine whether it’s time to impose a level of exhaustion:
The first and simplest option is to set a maximum amount of time between long rests that your party can go before they suffer exhaustion.
If you’re playing a “hardcore” campaign with an emphasis on survival and wilderness exploration, then you could make this as short as 24 or even 18 hours. Basically, if the party skips a long rest, tack on some exhaustion.
If you want to lighten this up a bit, keep the time, but allow a short rest to reset the clock as well as a long one. Also, let your players make Constitution saves to push through.
Food, water, but also torches, ammunition, rope, and other adventuring necessities are often all that stand between your players’ characters and an agonizing, ignominious death in the frozen arse end of nowhere.
If you’re playing D&D in survival mode, force your players to consume water every short rest, as well as food and water every long rest, or it’s exhaustion time. If you want to be less brutal, any long rest without food or water prompts a Constitution saving throw.
As mentioned above, the worse the environment, the quicker the players’ characters accrue levels of exhaustion. Now, extreme cold and scorching heat are all very well, but there are plenty of other unpleasant climates the players may venture through.
Oppressive humidity and clouds of biting mosquitoes can wear down even the hardiest warrior; steep hills or rolling sand dunes make the going incredibly tough, as do sprawling ruins broken up by piles of rubble and rotting beams.
I’ve even had a party start to suffer exhaustion as they tried to navigate a winding, labyrinthine administrative building, getting steady less able to function as they found themselves trapped in an endless loop of going to see Marge in billings, being told to fill out form 31C-R4J, trying to get form 31C-R4J, being told they’d need to get it from Marge in billings, etc.
By gauging the tone and challenge you want to present your players with, you can pretty quickly come up with your own rules and guidelines for when to impose exhaustion – or at least when to call for a Constitution saving throw.
There are, however, some instances where the rules explicitly mention imposed exhaustion that don’t relate to harsh environments, lack of food, and fatigue.
Sickening Radiance is a 4th level evocation spell available to the Wizard, Warlock, and Sorcerer classes. You emit an aura of dim, greenish light in a 30ft radius for 10 minutes – or while your concentration lasts. The light can spread around corners for extra uncanniness.
Any creature that moves into the spell’s area for the first time on a turn or starts its turn there must make a Constitution saving throw or suffer 4d10 radiant damage and gain one level of exhaustion. It also prevents anyone affected from becoming invisible. The exhaustion dissipates when the spell ends.
Now, while it’s definitely not great that you don’t get to permanently apply exhaustion, I maintain this is a hugely underrated boss fight spell. If you can surprise your enemy, use your frontliners to tie them up (or a use of the hold person spell, or something similar) for three or four rounds, you can effectively cut a huge monster with hundreds of hitpoints in half.
The Path of the Berserker Barbarian
All Barbarians can fly into a murderous rage, but the Berserker subclass takes things even further. When a Berserker Barbarian rages, they can decide to double down and whip themselves into a frenzy.
If you choose to enter a frenzy, you gain the ability to make a single melee weapon attack as a bonus action on each of your turns after the one when you rage. The effect lasts for the duration of your rage and, when your rage ends, you suffer one level of exhaustion.
Chases and other use cases
One of the only other ways you can explicitly gain a level of exhaustion is by dashing too many times during a chase. As stated in the Dungeon Master’s Guide (pg. 252), during a chase, anyone can freely use the dash action a number of times equal to 3 + your Constitution modifier.
If you want to dash more than that, each time you try to do so, you need to make a DC 10 Constitution ability check or gain a level of exhaustion.
Spells can give you hit points back, abilities can buff you with temporary hp, but when it comes to removing exhaustion, there’s really no substitute for a good night’s sleep.
There are some spells that remove exhaustion, like the 5th level spell, Greater Restoration, which is available to Bards, Clerics, and Druids, and removes one level of exhaustion, although this can start getting expensive:
Also, the Potion of Vitality listed in the Dungeon Master’s Guide can remove all levels of exhaustion you are suffering from.
Chugging extremely rare potions and burning high level spell slots, however, isn’t a sustainable way of dealing with exhaustion. The best thing to do is to make camp somewhere safe and catch some good old-fashioned shut-eye.
Each time you complete a long rest, if you are suffering from exhaustion, your exhaustion level is reduced by 1. This is the main reason why exhaustion is to be feared and respected.
If you’re unlucky (or foolish) enough to accumulate three or even four levels of exhaustion, you’re going to be out of commission for nearly a week if you want to get yourself back to fighting fit.
If you want or need to keep adventuring, you’d better prepare yourself for some bad rolls over the next few days.
Frequently Asked Questions
What causes exhaustion in DnD 5e?
Anything from too little sleep, food, or water, to a hostile climate, can cause exhaustion in D&D 5e. Largely, it’s up to the DM to set their own rules for when exhaustion is triggered.
Does exhaustion get a save?
Usually, yes. But sometimes the situation is so dire that the DM may just rule that you accumulate a level of exhaustion without a saving throw. Most of the time, however, the DM will call for a Constitution saving throw.
Can exhaustion kill you in DnD 5e?
Yes. If you accumulate 6 levels of exhaustion, you die without making any death saving throws.
Does greater restoration remove exhaustion?
Yes. Sort of. The 5th level spell Greater Restoration reduces the target’s exhaustion level by 1.