A Guide to Suffocation & Holding Breath in 5e, Martial arts instructor demonstrating a choke hold on one of their students

A Guide to D&D 5e’s Rules on Suffocation & Holding Breath

The dangers of being an adventurer in Dungeons & Dragons 5th Edition are numerous and often magical. But, sometimes the more mundane dangers are some of the most frightening for player characters. One such danger is the threat of suffocation since there are few ways around it in 5e.
What are the rules on suffocation in D&D 5e? How long can a creature hold its breath? And, how and why would a Game Master use suffocation in an encounter?

Let’s start by looking at the explicit rules for suffocating in the Player’s Handbook.

Rules on Suffocation in 5e

D&D 5e includes specific rules on suffocation which involve a creature falling to 0 hit points and dying. These rules are not instant death sentences as there are stages to suffocating in 5e, but the danger of dying is very real.

5e’s rules for suffocation come from Chapter 8: Adventuring of the Player’s Handbook:

When a creature runs out of breath or is choking, it can survive for a number of rounds equal to its Constitution modifier (minimum of 1 round). At the start of its next turn, it drops to 0 hit points and is dying, and it can’t regain hit points or be stabilized until it can breathe again.

Source: DnD Beyond | Basic Rules – Chapter 8: Adventuring

We’ll get into how long a creature can hold its breath in the next section. So, let’s look at how suffocating works in 5e.

First off, once a creature runs out of breath or starts choking (i.e., some hostile entity is actively strangling that creature), they maintain consciousness for a number of rounds equal to their Constitution modifier. Outside of combat, that basically means taking a creature’s Constitution modifier and multiplying it by 6 for a number of seconds they can survive while suffocating (since 1 combat round in D&D equals roughly 6 seconds or "real" time). Of course, some creatures have a +0 or negative Constitution modifier, so 5e’s suffocation rules give all creatures a minimum of 1 round (or 6 seconds) before they start dying.

So, a Barbarian with a 16 in Constitution has a +3 modifier. This means they can survive 3 rounds (or 18 seconds) once they start suffocating.

If you want a refresher on Ability Score modifier, see the table from this D&D Ability Scores article to see corresponding modifiers.

Next, after a creature suffocates, they drop to 0 hit points and start dying. Put differently; they drop to 0 hit points, fall unconscious, and start making death saving throws.

Typically, the best way to rescue a character making death saves is to stabilize them (via some method like a Wisdom (Medicine) check or spare the dying) or to heal them (through an ability or some kind of healing spell). But, the interesting thing about making death saves and 5e’s suffocation rules is a creature cannot be stabilized or gain hit points while suffocating. So, given enough time, a suffocating creature in 5e will die unless they become able to breathe again.

Here’s an example.

Let’s say the party including a Wizard (Constitution 10), Fighter (Constitution 16), and Cleric is taking a short rest along the edge of a forest. Suddenly, thick vines erupt from the earth and wrap around the Wizard’s neck and restrain the Fighter. The Cleric was far enough away to avoid being targeted. Now, these are tough, thick, possibly magically enhanced vines, so the Cleric and the Wizard can’t break the latter free. Since they were caught off guard, neither the Fighter nor the Wizard were able to catch their breath, so after 6 seconds, the Wizard passes out, falling unconscious and dropping to 0 hit points. Despite the Cleric casting healing word, the Wizard doesn’t regain lost hit points nor do they stabilize because the vines continue to squeeze their neck.

Of course, this is an extreme example, but you can see the danger suffocating poses for even high-level parties if they can’t start breathing after falling unconscious.

Suffocating in 5e & Death Saving Throws

A suffocating creature that drops to 0 hit points starts making death saving throws as normal. However, the rules for suffocation mean that creature can not become stable while suffocating. This means a suffocating creature will die due to eventually failing 3 death saves.

Ordinarily, if you succeed at 3 death saves in 5e, your character stabilizes. But, if they’re suffocating, that’s no longer an option as the rules for suffocation explicitly state a creature can’t become stable while suffocating.

Similarly, rolling a 20 on a death saving throw usually means that character regains 1 hit point and consciousness. However, the rules for suffocation also state that a dying creature can’t regain hit points while suffocating.

So, once your character starts making death saves while suffocating, it’s only a matter of time before they die. Your character won’t stabilize until their can breathe again, so you’ll keep rolling death saving throws until either A) they stop suffocating and get stabilized or B) they eventually roll 3 failures and die.

Basically, a suffocating character making death saves will eventually die because they won’t be able to stabilize or regain hit points until they stop suffocating.

How Long Can a Character Hold Their Breath?

Holding Breath 5e, Woman pinching her nose and holding her breath under water

Player characters and creatures in D&D 5e can hold their breath a number of minutes equal to 1 + their Constitution modifier. As such, hardier creatures (that is, those with higher Constitution scores) are able to hold their breath for longer periods of time.

The rules for how long a creature can hold their breath can be found in Chapter 8 of the Player’s Handbook:

A creature can hold its breath for a number of minutes equal to 1 + its Constitution modifier (minimum of 30 seconds).

Source: DnD Beyond | Basic Rules – Chapter 8: Adventuring

So, every creature in 5e can hold their breath for at least 30 seconds as the rules explicitly state the minimum. This is because a creature with a negative Constitution modifier would otherwise reduce how long their can hold their breath to 0 or even negative minutes which wouldn’t make sense.

After that, the base starts at 1 minute or 10 rounds of combat. You then add a player character’s or creature’s Constitution modifier to that.

As an example, a Barbarian with a 16 Constitution score has a +3 modifier. So, character would be able to hold their breath for up to 4 minutes before they start suffocating.

Now, this applies to Game Master-controlled creatures as well. So, a default Bandit can hold their breath for up to 2 minutes (12 Constitution, +1 modifier) and a Goblin can only do so for the base 1 minute (10 Constitution, +0 modifier).

Exceptions to 5e’s Holding Breath Rules

Now, some creatures and characters come with exceptions to the typical rules for holding their breath in D&D 5e.

The Air Genasi playable race comes with the Unending Breath trait which allows them to hold their breath for as long as they want regardless of their Constitution modifier while not incapacitated. Similarly, Tortles can hold their breath for up to 1 hour due to their Hold Breath trait.

As a player, make sure to read your character’s traits and features carefully. Your character may have an ability which allows them to hold their breath for an inordinately long time, prolonging how long they can last before suffocating and possibly giving you more time to help the other player characters.

As a Game Master, you need to check monster stat blocks and descriptions for breathing requirements.

For example, most undead don’t even need to breathe. So, if the players lock a bunch of zombies in an airtight cell or trap them underwater, those zombies aren’t going to suffocate. Just make sure to double-check if a monster can hold their breath for longer or if they need to breathe at all.

Casting Spells While Suffocating in 5e

Reason stands that a spell requiring a verbal component can not be cast while suffocating in 5e. To cast these spells, the caster needs to have breath to incorporate the verbal component.

5e’s spellcasting rules specifically outline how Verbal components work in Chapter 10: Spellcasting of the Player’s Handbook:

Most spells require the chanting of mystic words. The words themselves aren’t the source of the spell’s power; rather, the particular combination of sounds, with specific pitch and resonance, sets the threads of magic in motion. Thus, a character who is gagged or in an area of silence, such as one created by the silence spell, can’t cast a spell with a verbal component.

Source: DnD Beyond | Basic Rules – Chapter 10: Spellcasting

Basically, spells requiring a Verbal component involve speaking. Verbal components don’t rely on the specific words, but more on the pitch and resonance. As such, a creature that is suffocating is usually unable to cast spells that need Verbal components.

A suffocating creature has no breath left. At that point, they wouldn’t be able to clearly dictate the Verbal components for their spells. Similarly, a creature getting choked or strangled wouldn’t be able to cast these spells due to their inability to properly breathe.

Now, if your character is holding their breath, your Game Master might allow them to expel their breath to cast a spell. But, after that, your character would start suffocating.

Of course, if a spell doesn’t require a Verbal component, a spellcaster may use it freely while suffocating (following any other potential restrictions like shackles or a lack of focus or Material components). Somatic components requires specific gestures and Material components work with either the specific items or a focus, and neither rely on a character’s ability to speak. So, spells like catapult or the new 2nd-level spell from Spelljammer: Adventures in Space air bubble could be cast while suffocating.

Simply put; if a spell requires a Verbal component, it can’t be cast while suffocating in 5e. On the other hand, if a spell doesn’t require a Verbal component, it may still be used even if the caster can’t breathe.

For GMs: Using the Threat of Suffocation in Your Games

Suffocation 5e, Person tugging at a fuzzy choker around their neck

Suffocation is a solid, mundane hazard to use in your games. While there are abilities to mitigate or negate the threat, most player characters, regardless of level, need to breathe and placing them in situations with rapidly depleting air challenges them differently than combat or even other non-magical obstacles.

The lack of breathable air is a much more difficult hazard to overcome than other obstacles like difficult terrain or areas that are heavily obscured. Many challenges player characters face have at least a few defined abilities for overcoming them. But, suffocation doesn’t have that many ways to get around it.

Very few spells and class features work in such a way to fill a space with breathable air. The magnificent mansion spell creates an extradimensional space to possibly escape suffocation, but it has a casting time of 1 minute, much longer than a character has before they suffocate; requires a Verbal component, so the caster can’t hold their breath; and is a 7th-level spell, meaning the character needs to be at least 13th-level to cast it to begin with. That said, Spelljammer: Adventures in Space introduced the 2nd-level spell air bubble which produces a small pocket of breathable air for 1 target creature. For low-level adventurers in a party of 3 or 4, that’s still a heavy price to pay since the caster may only be able to cast it on a couple of the player characters.

So, even high-level characters don’t have a lot of options for dealing with suffocation in 5e.

Of course, specific characters may have an ability to deal with a lack of air like the Air Genasi. But, that then gives that player a chance to shine while they figure out how to save the other characters.

Basically, you should use the threat of suffocation in your game more than the actual act. This usually means giving your players a time limit as their source of air depletes. Eventually, if the party can’t escape, they’ll start suffocating and things will become much more dire.

Some encounters you could introduce to use the threat of suffocation in your games include:

  • A relatively large cavern experiences a cave-in, sealing off airflow giving the player characters a set amount of time before running out of air
  • Water begins rapidly flowing into a sealed room, eventually filling it completely
  • The building the party is in is enchanted to be airtight, putting a time limit on the player characters
  • While investigating sunken desert ruins, a crack splits in the ceiling and starts pouring sand in at an alarming rate
  • A sealed room has its perimeter erupt in flame, the fires start burning the oxygen faster than it can flow in and the smoke begins choking any creature within

Suffocation in 5e FAQ

What Happens If a Creature Drops to 0 Hit Points While Suffocating?

When a creature drops to 0 hit points while suffocating in 5e, they start dying and making deaths saves as normal if applicable. However, a creature can not be stabilized while suffocating; meaning player characters will eventually die without air.

A creature that drops to 0 hit points while suffocating starts making death saving throws as normal. The difference is a suffocating creature can’t become stable while suffocating even if they roll 3 successful death saves or regain hit points from anywhere. They need to be able to breathe first then become stable or regain hit points.

Is Suffocating the Same as Taking Damage?

No; suffocating in D&D 5e is not the same as taking damage. When a creature starts suffocating, they drop to 0 hit points as a result of the suffocation, not because they "take" damage from it.

A creature doesn’t take any damage as the result of suffocating in 5e. Instead, they simply drop to 0 hit points once they start suffocating which is different than taking damage to drop to 0. So, abilities which mitigate damage don’t work to prevent becoming unconscious due to suffocation.

Can You Suffocate During a Long Rest?

5e’s rules for long rests don’t specifically exclude the possibility of a creature suffocating during the rest. So, if some effect causes a creature to start suffocating while they sleep or during a long rest, there’s nothing against the rules for this happening.

There’s nothing explicitly preventing a creature from suffocating during a long rest in 5e. Of course, something needs to cause the suffocation like a strangling vine or the sudden creation of a vacuum around that creature.


Summary of D&D 5e’s Rules for Suffocating

That covers just about everything around how suffocation works in D&D 5e.

A creature can hold their breath for a number of minutes equal to 1 plus their Constitution modifier and for a minimum of 30 seconds. After that, a creature has a number of rounds equal to their Constitution modifier (or multiplied by 6 for the number of seconds) until they suffocate. At that point, they drop to 0 hit points and can’t become stable or regain hit points until their can breathe again.

Have you run an encounter with the threat of suffocation as a part of the danger? How would you work an encounter around the character’s holding their breath into your game? Leave a comment below with your thoughts!

Make sure to follow Role Player’s Respite for more rules break downs, guides on how to run your game, and inspiration!

1 thought on “A Guide to D&D 5e’s Rules on Suffocation & Holding Breath”

  1. The article mentions a creature is choking when some hostile entity is actively strangling that creature, but there are no rules that I know of in D&D 5e for strangling someone (even though it’s a relatively common way to kill or assassinate someone). If a barbarian wants to strangle a wizard to prevent them from casting spells with a verbal component or even kill them, what rules do we apply?

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