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.

Level Effect
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
6 Death

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. Also, being raised from the dead reduces a creature’s exhaustion level by 1.

Player’s Handbook, pg.

Exhaustion 5e

Exhaustion is a special condition in DnD 5e that can either come about a few ways explicitly in the rules, as well as at the DM’s discretion when the players engage in exhausting work. Its many levels can be extremely punishing and hard to remove, leading many DMs to forget the mechanic altogether.

While One DnD had plans to overhaul the exhaustion system, the new ruleset was removed from the latest playtest materials. Which is odd, because many seemed to really like the change. Mayhaps they’re designing an even better system? One can hope.

In any case, this article will cover the current rules for Exhaustion in 5e, circa May 2023.

What Does Exhaustion Do in 5e?

Exhaustion reduces the capabilities of a character in various ways in 5e. It comes in six ascending stages that become progressively worse. If a character is already exhausted and suffers exhaustion again, its level of exhaustion increases.

A character suffers the effect of all previous levels of exhaustion; for example, if you’re exhaustion level is 3, you suffer the effects of exhaustion levels 1, 2, and 3.

Exhaustion ends if reduced to a level below 1. Finishing a long rest reduces exhaustion level by 1, as long as you eat and drink. Being raised from the dead also reduces a creature’s exhaustion level by 1.

Other effects can reduce exhaustion level(s) as well; more on those later. For now, here’s more detail on each level of exhaustion:

Level 1: Disadvantage on ability checks

Quite annoying, but not really a hindrance to your combat readiness unless your character relies on Grappling and/or Shoving in a fight. Although initiative checks are ability checks, so you’ll likely be lower in the initiative order with this debuff, which seems fitting for an exhausted character.

Outside of combat, disadvantage on ability checks means Stealthing, all social encounters, and your ability to perceive/investigate things will all be much worse.

Already, this is quite a punishing effect. But if only one party member is suffering from it, it’s not a big deal — let the other people do the skill checks and you’re fine.

Level 2: Speed halved

Very painful in combat, especially if you require mobility to fight effectively (e.g., Rogues, Monks, all melee martials to some degree).

Also can be the source of a death spiral if you’re trapped in an environment that’s causing you to become more exhausted, moving at half-speed and all.

Level 3: Disadvantage on attack rolls and saving throws

Up until now, your offensive and defensive capabilities haven’t really been touched. At 3 levels of Exhaustion, they are thoroughly diminished.

Disadvantage works out to something like -5 average on a d20 roll, so you’ll be hitting much less often with all your attacks. That also goes for death saving throws, making this debuff especially dangerous for death spirals.

On this plus side, if you’re a spellcaster, you can still rely on saving throw-based spells to be as offensively threatening as you’d be if you weren’t exhausted.

Disadvantage on all saving throws is defensively horrible. Enemy spells are usually the scariest element of a fight, and they’re about to start landing/dealing full damage almost all the time with this debuff on you.

Level 4: Hit point maximum halved

Healing can’t help; your character’s hit points are basically at half what they should be for your level. Taken together with the other effects of Exhaustion, you can no longer fight safely or effectively at this point.

Level 5: Speed reduced to 0

Unless someone else can save you or you can rest wherever you are, this is the beginning of the end for your character.

Level 6: Death

So tired, you die.

What Causes Exhaustion in 5e?

The following things cause Exhaustion in DnD 5e, according to official materials:

  • Travel effects:

    • Forced March. If you travel more than 8 hours in a day, you must make a DC 10 + 1 for each hour past 8 hours Constitution saving throw, suffering one level of exhaustion on a failure (PHB 181).

    • Swimming. Every hour of swimming forces a DC 10 Con save, +1 level of exhaustion on failure. Swimming at a depth of 100+ feet, you make this roll every 30 minutes. At a depth of 200+ feet, every 15 minutes (DMG 116-7).

    • Dashing. During a chase, a creature can dash 3 + its Constitution modifer times. Each additional dash forces a DC 10 Con save, +1 level of exhaustion on a failure. All exhaustion gained during a chase can be removed by taking a short or long rest.

    • Going without food or water. A character can go without food = to 3 + their Constitution modifier (so 5 days with a +2 Constitution modifier). At the end of each day beyond that, a character suffers one level of exhaustion. This must be at least one pound of food, or half a pound counts as going half a day without food.

      Characters need one gallon of water, or two on a hot day, every day. If a character drinks half+ that much must pass a DC 15 Con save or suffer one level of exhaustion at the end of the day. A character who drinks less than half automatically suffers one level of exhaustion.

      If you’re already exhausted, you suffer two levels of exhaustion if you fail the Con save or don’t drink at least half the required amount of water.

    • Failing to sleep. Whenever you end a 24-hour period without a long rest, you must pass a DC 10 Con save or suffer one level of exhaustion. This increases by +5 for each consecutive 24-hour period you go without a long rest (XGtE 79).

      Note that creatures who don’t need to sleep, like Elves, can never suffer exhaustion from a lack of sleep. Or if a character has a feature that allows them to forgo sleep, like Aspect of the Moon Eldritch Invocation or Undead Warlock’s Grave Touched feature, they also never suffer exhaustion from a lack of sleep.

  • Environmental effects:

    • Extreme cold. Whenever the temperature is below 0 degrees Fahrenheit (-18 Celcius), exposed creatures must pass a DC 10 Con save each hour or gain +1 level of exhaustion. Cold-immune or cold-adapted creatures automatically pass, as do creatures wearing appropriate gear for the cold (DMG 110).

    • Extreme heat. When the temperature is 100+ degrees Fahrenheit (38 Celcius), exposed creatures without access to drinkable water must pass a Con save each hour or gain +1 level of exhaustion. DC = 5 + 1 for each hour. Medium or heavily armored creatures have disadvantage on this roll. Fire-immune or heat-adapted creatures automatically pass this saving throw (DMG 110).

    • Frigid water. A creature can spend (Constitution modifier) minutes in frigid water before suffering any ill effects. Each additional minute forces a DC 10 Con save, with +1 level of exhaustion on each failure. Cold-immune or cold-adapted creatures automatically pass this save (DMG 110).

    • Avalalances. Every 5 minutes a creature spends buried causes them to gain 1 level of exhaustion (TCoE 169).

    • Cackle Fever. 1d4 hours after infection, a creature gains one level of exhaustion that can’t be removed until the disease is cured (DMG 257).

    • Sewer Plague. 1d4 hours after infection, suffer one level of exhaustion and regain half hitpoints from Hit Die and no hit points from long rest. At the end of each long rest, an infected creature must pass a DC 11 Con save or +1 level of exhaustion (succeeding reduces exhaustion level by 1, recovering from a disease once reaching 0) (DMG 257).

  • Realm effects:

    • Outer planes effects. Psychic dissonance that causes a creature of incompatible alignment to make a DC 10 Con save at the end of long rests or suffer +1 level of exhaustion (DMG 59).

    • Pademonium effects. Howlings winds that force a DC 10 Wisdom save every hour spent here or suffer +1 level of exhaustion (DMG 62).

    • Hades effects. DC 10 Wisdom save at the end of long rests or +1 level of exhaustion, unremovable while in Hades. Turn into a larvae instead of dying if you suffer 6 levels of exhaustion in Hades (DMG 63).

    • Far Realm effects (64-72). Get lost for 2d10 hours and pass a DC 10 Con save or +1 level of exhaustion (TCoE 152).

    • Haunted effects (96-100). 50-food sphere of dense mist. Any creature in it must pass a DC 10 Con save or +1 level of exhaustion, which can’t be removed while in this mist (TCoE 155).

    • Primal fruit (2). Advantage on Strength attack rolls, checks, and saves for 1 hour, followed by +1 level of exhaustion (TCoE 169).

  • Some monster abilities:

    • Gingwatzim (CR2) – Energy Drain

    • Jade Tigress (CR 6)Poison Dart

    • Soul Monger (CR 11) – Wave of Weariness

    • Sibriex (CR 18) – Warp Creature

    • Kalaraq Quori (CR 19) – Mind Seed

  • Sickening Radiance. 4th-level spell avaialle to Sorcerers, Warlocks, and Wziards. If a creature ends its turn in the 30-foot-radius of this spell and fails a Constitution savig throw, it suffers one level of exhaustion.

  • Berserker Barbarian Frenzy. Level 3 subclass feature that lets you make +1 bonus action melee attack each turn while Raging. After Rage ends, the Barbarian suffers +1 exhaustion level. This is the only subclass feature to cause exhaustion.

  • Common house rules: Falling to 0 hit points. Many DMs feel that players falling to 0 hit points 3-4 times in a fight, only to be brought up with a Healing Word each time, to not be punishing enough. This yo-yo style of metagaming is efficient but doesn’t feel narratively correct.

    So, the idea is that you suffer 1 level of exhaustion when brought to 0 hit points. Some house rule it so it can only happen once per fight (because the yo-yo thing is still gonna happen, and it can quickly become TOO punishing, requiring 3-4 days of rest to recuperate — not exactly fun). Or rule that being brought back to 1 hit point forces a Con save that MIGHT give you a level of exhaustion if you fail.

    This idea often extends to resurrection, as well.

D&D 5e dice

How to Remove Exhaustion in 5e

Here are the only book-official ways to remove Exhaustion in DnD 5e:

  1. Rest. Taking a long rest removes one level of exhaustion. Keep in mind that resting in medium or heavy armor doesn’t reduce your exhaustion level (XGtE 77-8), and you’ll need to make Con saves if you’re taking a long rest in an environment that forces Con saves to avoid gaining levels of exhaustion; otherwise the rest will have 0 net benefit.

    Rangers also have the 10th-level Tireless feature that removes one level of exhaustion on a short rest as well.
  2. Greater Restoration. 5th-level spell that removes 1 level of exhaustion, among other negative effects.

  3. Potion of Vitality. A very rare potion (11th-level or higher) that removes all exhaustion levels, as well as diseases and poisons. You also gain max hit points for any Hit Die you spend for the next 24 hours.