Now my current 5e campaign (Tomb of Annihilation) is almost over, I’m beginning to think about the next one. Here is how I will implement rest and healing:

The first two are optional rules from the DMG, the third comes from Xanathar’s Guide to Everything and the last two are house rules (although I’m pretty sure I saw the last one somewhere else).

No automatic return to full hit points

Characters don’t get restored to full hit points after a long rest. They do get half their hit dice back, and they can spend hit dice as soon as the end of the rest period, subject to the rule below.

Dependency on healing kits

A character who spends one or more hit dice to get hit points back at the end of a short or long rest needs to expand one use from a healer’s kit.

Necessary long rests

A character who goes without long rests makes a Constitution save every 24h. The DC starts at 10 and raises by 5 for every 24h period. Each failed save gets the character an exhaustion level. The save DC gets reset to 10 the next time the character takes a long rest.

Sleeping in armor

A character who sleeps (spends a long rest) in armor makes a Constitution save, with a DC equal to the armor base AC (so 11 for a leather armor, 16 for chain mail…). On a failed check, the character does not benefit from the long rest. If the check is failed by 5 or more, the character gains an exhaustion level.

Healing potions

The 25gp healing potion in the base equipment list is not the same as the magical healing potion from the treasure table. It does not grant hit points by itself, but it allows a character to spend one hit die to regain hit points as an action. In addition, the player can roll the die twice and keep the better result.