Quicklinks: Exhaustion Causes, Levels, Removal, Radiation | Personal Needs Breathing, Food & Water, Sleep, Hygiene | Humanity


Exhaustion represents the consequences of ignoring your personal and physical needs. Any time you ignore your personal needs or suffer a significant injury, you will gain a level of exhaustion.

Causes of Exhaustion

There are several causes of Exhaustion. Below is a list of the most common ways that you acquire levels of exhaustion:

  • When you a suffocating (see below under Breathing)
  • When you do not eat or drink during the day (see below under Food & Water)
  • When you do not receive adequate sleep each day (see below under Sleep)
  • When you suffer damage equal to half of your hit points or more from a single source (see Damage & Healing: Hit Points)
  • When you make a death saving throw (see Damage & Healing: Dying)
  • When you take laser damage (see Damage & Healing: Damage Types)
  • When you are exposed to some hazards, such as intense cold and heat (see Hazards)
  • When you are exposed to Elemental Radiation (see Planar Effects & Influences: Primordial Planes).

Levels of Exhaustion

As you gain more levels of exhaustion, you will suffer greater penalties when performing tasks as you begin to become more weakened and exhausted.

  • You have disadvantage on all skills that have a modifier that is equal to or less than your level of exhaustion.
  • If your exhaustion is 4 or greater your movement speed is halved.
  • If your exhaustion is 8 or greater all of your ability score derivatives are halved.
  • If your exhaustion is 12 or greater, you are reduced to 0 hit points and begin dying.

Removing Exhaustion

There is only one natural way to remove levels of exhaustion and that is to sleep and rest over time. Any time you sleep for 8 or more hours a day, you will remove levels of exhaustion. Sleeping for more time has added benefits (see below for Sleep), but these benefits diminish over time.

You can also recover faster using medical interventions and pharmaceuticals (see Pharmaceuticals).

Radiation-Induced Exhaustion.

Any levels of exhaustion you gain from elemental radiation can only be removed through advanced medical interventions and can not be recovered from through sleep alone. Any medical intervention, effect, or device that cures exhaustion will not cure radiation-induced exhaustion; it must specifically state that it cures radiation-induced exhaustion.

Personal Needs

In order to remain alive you must cater to your basic needs. This includes the need to drink, eat, sleep, and breathe. The sections below describe the requirements for meeting these needs and what the consequences are if you ignore them.


Your lungs require a constant flow of air to keep you alive.

Suffocation. When you run out of air or choose to forgo breathing in air, you begin to suffocate. The duration that you can endure is based off of your Hold Breath. If you have been suffocating for the entire length permitted by your Hold Breath, you gain 1 level of exhaustion every round (6 seconds) until you choose to breathe.

Prepared Suffocation. When you know that you will be without air for an extended period of time, you can use an action to take in a lungful of air and double the length of your Hold Breath. This bonus lasts until you breathe again.

Extraplanar Breath. You have the ability to breathe in any plane of existence (including Astral Space), unless extenuating circumstances or a plane’s effect prevents you.

Food & Water

You must eat and drink enough food and water in a day in order to remain healthy.

Required Food. A healthy adult needs 3 meals a day. You gain 1 level of exhaustion for every meal you skip in a 24 hour period. One ration is enough food for a single meal, though depending on location, food can often be purchased much cheaper.

Required Hydration. You must drink 1 gallon of water (or comparable liquid) a day. You gain 1 level of exhaustion for every quarter gallon missing in a 24 hour period.

Overconsumption. You gain 1 level of exhaustion and must make a DC18 Fortitude saving throw against Nausea ailment if you eat a meal within 3 hours of your last meal. Nausea gained in this way lasts 24 hours.

Force Feeding. If you are unwilling or unable to eat, other creatures can force you to consume food or water to keep you alive or force you to overconsume. This is usually done with hospital or medical equipment, but can be done through brute force.


All humans need to sleep in order to heal their bodies and recover from the day’s activities. In order to fully benefit from sleep without consequences, you must have an extended period of downtime every 24 hours where your character falls unconscious into a state of sleep.

Sleep Duration. Depending on how long you sleep you receive different penalties and benefits. Round the duration slept down to the nearest hour.

  • 0-1 hours: You gain 3 levels of exhaustion.
  • 2-3 hours: You gain 2 levels of exhaustion.
  • 4-5 hours: You gain 1 level of exhaustion.
  • 6-7 hours: You heal 1 damage.
  • 8-9 hours: You heal 1 damage, recover 1 level of exhaustion, and recover 1 mana.
  • 10+ hours: You heal 1 damage, recover 2 levels of exhaustion, and recover 2 mana.

Interrupted Sleep. If your rest is temporarily interrupted, you can return back to sleep without it counting against your sleep duration as long as the total time you spend awake is less than 20 minutes.

Uncomfortable Sleep. In order to fully benefit from sleep, you must rest in a location that is comfortable (such as a bed, a mattress, or a piece of soft furniture). When you rest in uncomfortable conditions (such as sleeping on the ground with no mattress, in fiber or armor, or in bad weather) you gain 1 level of exhaustion after the first 1 hour of rest.


It is generally assumed that you are following proper hygiene to keep yourself healthy and to maintain your appearance. This includes regularly washing your hands with soap, showering or bathing, and grooming yourself.

However, in situations where you cannot realistically follow proper hygiene due to a lack of proper facilities, proper equipment (such as soap), or clean water, there are penalties to both your personal comfort and your social skills.

Personal Comfort. If you do not maintain an acceptable level of cleanliness, you may suffer penalties or disadvantage on skill rolls due to you being uncomfortable or exposed to illness. You also may suffer penalties when trying to sleep or concentrate on a task.

Social Situations. If you let your hygiene become particularly poor, you may become crippled in social situations and creatures may gain social cover, or outright immunity, against you.

How often you need to bathe or groom yourself is determined by the activities you are performing and your current environment. For example, performing physically strenuous activities on a hot, humid fragment will require you to bathe more frequently than performing skills in a climate controlled building.


Humanity represents your connection to your soul. Installing bio-modifications into your body or encountering extraordinary extraplanar effects can lower your humanity. A character with a low humanity will find the chamber of their soul weakened.

You have a humanity of 5. Installing a bio-modification will reduce your humanity by 1. There are no negative effects for having a reduced humanity. However, if your humanity is ever reduced below 0, your connection to your soul severs and you suffer what is known as soul death.

Soul Death. When you experience soul death, your chamber of the soul becomes inaccessible and you lose all connection to your projections. You become a feral entity without the ability to reason or communicate. There is no process to undue soul death and your character is uncontrollable and non-playable.