Mechanical Thinking: Exhaustion as Damage

Mechanical Thinking is a series that presents new houserules that you can add to your home D&D games, and then interrogates the underlying mechanics, examines what problems the rule solves, and identifies what the rule can do to improve your game. Then, once all is said and done, join me and other readers in the comments for a discussion about the proposed rule. Just remember that all rules have their place, and while they might not fit your table, they might be perfect for another gaming group.

If you have a mind for mechanics or for the process of game design, or if you want hone the mechanical side of your RPG knowledge, this series is for you!


Exhaustion is a six-step stamina counter unique to fifth edition Dungeons & Dragons that tracks a creature’s physical state from peak condition to death. Unlike hit points, which increase as a character gains levels, exhaustion always remains the same. Likewise, every point of exhaustion a creature gains imposes a cumulative and debilitating effect, ranging from unpleasant-but-minor disadvantage on ability checks at a single point of exhaustion, to complete immobility at five points, to instant death at six points.

Exhaustion’s “death spiral” effect sometimes feels at odds with D&D’s heroic nature, which is best exemplified by hit points—a health tracker that allows a character with only a single remaining hit point to fight just as effectively as a character at full hit points. For that reason, effects that impose exhaustion are mercifully rare in D&D’s rules and adventures—and this scarcity is merciful, as there are precious few ways of recovering from exhaustion. Nevertheless, if you want to add a bit of grit to your D&D game, consider expanding the role of exhaustion:

Exhaustion as Damage

If you want to make combat more ruthless and visceral, try removing the abstract concept of hit points from your D&D and replacing it with an exhaustion track. This method is similar to, but distinct from, a mechanic introduced in the Star Wars Saga Edition roleplaying game, published by Wizards of the Coast in 2000 and revised in 2002. This mechanic was known as the Condition Track. In addition to damage (which drained a creature’s D&D-style hit points), Star Wars Saga Edition included effects that pushed their target down the Condition Track. Every time a creature advanced down the Condition Track, it suffered mounting cumulative penalties, ultimately resulting in unconsciousness. As was typical of the third edition D&D and the d20 System, these condition penalties were granular penalties to rolls; a character would advance from a –1 penalty to attack rolls, ability checks, and skill checks to a –2, a –5, and so forth.

Exhaustion in fifth edition bears some similarities to Star Wars-style conditions, but by making the penalties of exhaustion less granular, fifth edition actually made exhaustion more debilitating. Being able to move only half speed is a huge deal for only two points of exhaustion, and disadvantage on attack rolls at three points is massive, but to have your hit point maximum halved at four points? Fifth edition exhaustion doesn’t play around. Notably, a creature’s condition could be much more easily restored than D&D exhaustion, which can only be recovered point-by-point by completing a long rest, being soothed by greater restoration, or by consuming a rare potion.

Replacing Hit Points with an Exhaustion Track

You can adapt this idea to D&D by removing hit points entirely, and giving each class their own exhaustion track. A character’s exhaustion track is determined by the size of your class’s hit die, plus your Constitution modifier. For instance, a wizard or a sorcerer has a 6-step exhaustion track, because the wizard and sorcerer classes have a d6 hit die. Likewise, a fighter, paladin, or ranger has a 10-step exhaustion track because those classes have a d10 hit die. Finally, your character’s exhaustion track is extended by a number equal to your Constitution modifier; if your character’s Constitution modifier is negative, your track is reduced by that number of steps.  

Whenever you gain a level, your exhaustion track increases by one.  

Also, since the fourth step of the exhaustion track in the core rules is "hit point maximum halved," this step will have to be replaced. Instead, creatures that have reached this step can only take an action or a bonus action on their turn, not both. Additionally, they can't take reactions.

Creatures with Exhaustion Tracks Longer or Shorter than Six Steps

Under this system, most creatures have an exhaustion track more than six-steps long. For instance, a wizard with a +1 Constitution modifier has a 7-step exhaustion track. However, since there are only six steps of exhaustion in D&D, every step of your track your character has above 6 is “safe.” Gaining a point of exhaustion has no effect until you enter the final six steps of your exhaustion track.

For example, a rogue (d8 hit die) and a +2 Constitution modifier has an exhaustion track that looks like this:

Level of Exhaustion







Disadvantage on ability checks


Speed halved


Disadvantage on attack rolls and saving throws


Can only take an action or a bonus action on a turn, and can't take reactions


Speed Reduced to 0




Similarly, if your exhaustion track is shorter than six steps, you suffer the effects of exhaustion in order (starting with disadvantage on ability checks at one point of exhaustion) but die when you reach the end of your exhaustion track. For example, a character with a 5-step exhaustion track dies after gaining five points of exhaustion, rather than having its speed reduced to 0 first.

Gaining Exhaustion when Taking Damage

In addition to the usual ways a creature become exhausted (such as through strenuous travel and dangerous environments), a creature gains a point of exhaustion whenever it takes damage. This damage could come from any source, such as an attack, a spell, or an environmental effect. Especially powerful attacks, environmental effects, and spells could cause more than 1 point of exhaustion, at the DM’s discretion. If a single attack or effect deals multiple types of damage, such as a flying snake's bite dealing both piercing and poison damage, this attack still only inflicts 1 point of exhaustion.


Whenever an effect would cause a creature to regain any number of hit points, it instead loses 1 point of exhaustion. If the healing effect is a spell that only targets a single creature, the spell causes its target to lose a point of exhaustion per level of the spell. Healing spells that target multiple creatures and restore large amounts of hit points, like mass cure wounds and mass heal are left to the DM’s discretion.

Also, lesser restoration now causes its target to lose 1 point of exhaustion in addition to its other effects. Lastly, greater restoration now causes the target to lose 2 points of exhaustion in addition to its other effects. A potion of healing causes the creature who drinks it to lose 1 point of exhaustion, a potion of greater healing restores 2 points of exhaustion, and so forth.

Finally, a creature can lose 1 point of exhaustion by spending a hit die when it completes a short rest. Restoring exhaustion further in the same short rest costs one additional hit die per point cured; for instance, curing three points of exhaustion in a single rest costs six hit dice, one hit die for the first, two for the second, and three for the third. 


Instead of having hit points, a monster has a number of exhaustion steps equal to its number of hit dice. Monsters exhaustion tracks work similarly to characters’ exhaustion tracks; if this number is less than six, the monster suffers the effects of exhaustion as normal, but dies after it gains points of exhaustion equal to its number of hit dice.


When a creature reaches the end of its exhaustion track, it dies. Unlike in the core fifth edition rules, no creatures make death saving throws. If you want your game to be more forgiving, consider allowing player characters and important NPCs to start dying when they reach the end of their exhaustion track instead of perishing outright. Dying creatures make death saves as normal.

Points of Stress in this House Rule

This house rule isn’t perfect. Fifth edition Dungeons & Dragons was designed with hit points in mind, and simplifying hit points into an exhaustion track has some serious drawbacks, in exchange for making your games less lethal in earlier levels and potentially more lethal at higher levels. It makes hordes of weak creatures incredibly dangerous, and creatures with many attacks (such as a marilith or a carrion crawler disproportionately powerful, since all attacks have the same effective power under this system, regardless of whether they would have dealt 10 damage or 100 in a hit point-based system.

Because of the way the power of certain spells and features fluctuate with this rule in place, Dungeon Masters may have to make ad hoc adjudications when translating the power of area-of-effect spells from hit point damage to exhaustion damage. As a simple house rule, these sort of adjudications are fine. If this system were translated into a full and exhaustive D&D-like spinoff game, a full rework of many monsters, spells, and features would be in order to suit this new mechanical framework.

Also, no exhaustion-as-damage houserule would be complete without addressing the “death spiral” effect, in which characters become less effect and less likely to succeed in a fight as the fight goes on. This effect is cushioned somewhat by allowing hardy characters to take multiple hits before suffering from exhaustion effects, but it is nevertheless still present. The death spiral effect on monsters also adds to the Dungeon Master’s mental load, as the DM now has to keep track of all the effects clinging onto their monsters throughout the course of an encounter and beyond.

What do you think of this new house rule? Would you use it in your game? What would you change? Let us know in the comments below!

James Haeck is the lead writer for D&D Beyond, the co-author of  Waterdeep: Dragon Heist and the Critical Role Tal'Dorei Campaign Setting, the DM of  Worlds Apartand a freelance writer for Wizards of the Coast, the D&D Adventurers League, and Kobold Press. He lives in Seattle, Washington with his partner Hannah and their animal companions Mei and Marzipan. You can find him wasting time on Twitter at @jamesjhaeck.


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