Can visual inspection tell the reason a creature is unconscious? Is there a difference between a creature that is sleeping normally, sleeping magically, or unconscious due to dropping to 0 HP? Does a stable creature at 0 HP look or behave different to an unstable one?

This came up in game last night after a character in darkness cast sleep on themselves. Another character moved to the unconscious figure. The player said "I shake them awake". My question was, "How do you know they are sleeping? They might be at 0 HP, in which case wouldn't the appropriate action be to use Lay on Hands?" Generally, if someone is unconscious in combat its because they have gone to 0 HP, in which case the usual course of action is healing magic or a medicine check to stabilise.

In short: The paladin saw an unconscious friend. Can they, without an Action, determine the cause of unconsciousness?

Since we are all at the same table, the players all knew that the wizard cast sleep at ground zero and put themselves out instead of their foes. However, the characters were far enough away that ingame they did not know what happened. All the paladin character knew was that they moved to within darkvision range and suddenly saw their friend unmoving on the ground. This was in combat, so the action economy was important.

It seemed to be bad metagaming for the player to pick the Action "shake the character awake" instead of "do some healing magic" or "stabilise" or "drag to safety" or something else.

I ruled that there is no perceivable difference between a normally-sleeping unconscious creature and a magically-sleeping unconscious creature and a at-0-HP unconscious creature. All are unmoving, and unresponsive. All are breathing and have a heartbeat. In the case above, the wizard had been wounded, so "lack of wounds" could not have been a clue.

My players disagreed. I'm unsure if my ruling was right.

  • \$\begingroup\$ Comments are not for extended discussion; this conversation has been moved to chat. \$\endgroup\$
    – Someone_Evil
    Commented May 27, 2020 at 13:11
  • \$\begingroup\$ @Izzy In the post, the OP mentions it was in combat. \$\endgroup\$
    – Axoren
    Commented May 27, 2020 at 13:32
  • \$\begingroup\$ Is your goal to justify your ruling? Find the faults in it? or figure out a better way to handle that meta-game situation? The context you provided goes beyond the question "How can you differentiate sleeping from other kinds of unconscious?" \$\endgroup\$
    – Axoren
    Commented May 27, 2020 at 13:36
  • 1
    \$\begingroup\$ Sleep has a verbal component. Presumably, the whole party would know that the unconscious player had cast Sleep and could logically deduce that they had self-targeted. \$\endgroup\$
    – Simon
    Commented May 27, 2020 at 16:26

5 Answers 5


To tell if someone is sleeping rather than unconscious:

  • Listen for snoring
  • Listen for regular breathing
  • Listen for the absence of struggling/ragged breathes
  • Listen for the absence of any disturbing sounds (blood gargling with every breath)
  • Look to see if they have any visible wounds
  • Look to see if they appear to be laying comfortable
  • Look to see if they are clutching anything
  • Look to see if they have a pained look on their face
  • Look to see if they are subtly reacting to the noise around them
  • Look to see if they are laying unnaturally
  • Look to see if they react to touch
  • Feel them for blood
  • Feel them to see if they react to sore areas
  • Shake them to wake them up
  • Poke/prod them
  • Say "wake up!" to them and see if they react
  • Make some other loud noise (eg stomping) and see if they react
  • Flash a light in their eyes and see if they react

There are limitless ideas for you to play around with. I think the most natural are shaking someone, or talking to them. Those two cover the vast majority of my experiences in real life and in media.

Forcing your players to play suboptimally is not fun for them

Most people find doing well to be fun. Yes, we all like to do something silly or flavorful sometimes, but that should be the player's choice. Being forced to do something that you know is bad or wrong sucks. It feels like you are being cheated or tricked.

If it's important, you do it

I don't know about your players, but mine don't fuss over the details. In that situation I would fill in the details; "you hear character snoring and run over to shake them awake" or "you see character sleeping peacefully and run over the wake them".

This isn't the right time for skill checks

The player already has the knowledge, you are asking them to justify the reason for having that knowledge. Gating that behind a skill check doesn't make any sense. We already know whatever method the player used has succeeded.

The player knows the character is sleeping, just let them have it even if you can't think of a justification.

  • \$\begingroup\$ Comments are not for extended discussion; this conversation has been moved to chat. \$\endgroup\$
    – Someone_Evil
    Commented Jun 2, 2020 at 18:54

Use a skill check

The rules state:

An ability check tests a character's or monster's innate talent and training in an effort to overcome a challenge [such as determining a creature's status!]. The DM calls for an ability check when a character or monster attempts an action (other than an attack) that has a chance of failure.

As a DM, I might allow any of the following skills to be used:


Given the various sensory clues available to the character (see below) attempting to discern if her ally is sleeping or in need of medical attention, can that character arrive at the correct answer?

Or maybe it's even higher order thinking: Given the general context, would it be possible for the second character to intuit that the first character would cast sleep on itself in response?


Does the character have any medical training/experience? This might not even be formal training. Given whatever experience the character has, can she leverage it to arrive at the correct answer?


You mention that the second character has darkvision. That would allow her to make a visual inspection. But even if the second character lacked this trait (or if the darkness were magical), Perception is still an option because, while it is probably most commonly used for vision-based checks, it applies to all the senses. The second character could listen for breathing/snoring, feel for a pulse or chest movement, or feel for any obvious wounds.


Sleep has a verbal component. Has the caster used the spell before? Would the second character recognize the spell's words/sounds and be able to identify it from this?

The spell Identify

If the second character has the ability to cast the spell Identify (and doesn't care about using its action to cast a spell when a "free" check might provide the same basic information), she can cast the spell to learn that the first character is affected by the spell Sleep.

Some other method

The most fundamental rules for playing D&D 5th edition are codifed thus:

  • The DM describes the environment.

  • The players describe what they want to do.

  • The DM narrates the results of the adventurers' actions.

The player is at liberty to devise a way to learn the status of an ally in an area of darkness. The list of solutions is limited only by one's imagination!

  • 3
    \$\begingroup\$ I suspect Investigation would also be appropriate. Investigation is about making deductions from clues so you could look at things like body position to deduce that the creature is sleeping/dead \$\endgroup\$
    – user60913
    Commented May 27, 2020 at 0:16
  • 1
    \$\begingroup\$ Insight is more about discerning intentions by looking at body language/speech. I think investigation (which is about looking at clues and making deductions) is the one you meant to say! \$\endgroup\$ Commented May 27, 2020 at 0:29
  • 3
    \$\begingroup\$ If you're suggesting Perception because assessing someone's injuries uses your senses, doesn't that apply to everything? "Tracking the werewolf would normally be Survival, but I'm tracking using my senses, so I want to use Perception instead." \$\endgroup\$
    – Mark Wells
    Commented May 27, 2020 at 1:19
  • 6
    \$\begingroup\$ Or, to be blunt, why is this anything other than Medicine? \$\endgroup\$
    – Mark Wells
    Commented May 27, 2020 at 1:22
  • \$\begingroup\$ I could see an insight check in that you could guess they are sleeping because of what you know of them as a person. It would be like looking at a monster and trying to guess its next action but retroactively. "What would the person, as I know them, have done in this scenario? Oh, they would cast Sleep on themselves because they would think that would be helpful" \$\endgroup\$
    – user60913
    Commented May 27, 2020 at 1:42

Just tell them.

Suppose you impose some barrier, such as a Medicine check, to know if they're injured-unconscious or just sleeping. Player tries it and fails. Then what?

  • The guy is sleeping but the PC thinks they're critically injured and uses a healing spell or something. Minor waste of resources, no big deal.
  • The guy is actually bleeding to death but the PC is shaking them and yelling "Hello, Parrot!" When this doesn't work, does the player get to say "Okay, clearly not sleeping, time for Lay On Hands" or does the bad roll force them to act stupid and let the guy die?

If they're going to learn the answer in a few seconds anyway, and there's no interesting consequence to being wrong, just give it to them.

  • 1
    \$\begingroup\$ OP said it was in combat, so there is a potential consequence for being wrong \$\endgroup\$ Commented May 27, 2020 at 10:55

In general there is no visible difference between a Sleeping character and a Magically Sleeping character however a character that has been rendered to zero hit points would show signs of what caused this event whether it be disheveled clothing as in the event of a struggle where they were choked into unconsciousness or visible wounds, etc. However this isn't the question you're actually asking.

What you're actually asking is how to prevent a player from Meta-gaming (that is using information the player knows but the Character does not). This is a common issue that people run into and there are a plethora of opinions on how to resolve this issue but I find that the most appropriate and most enjoyable is that you reintroduce the observations of the active character as they approach a situation or event they were not previously aware of.

Using your example when the Paladin enters the darkened area to find the Mage inform the player that their Character "sees the Mage slumped to the floor in the murky darkness before them blood trickling from the various wounds they have suffered" and then ask what they are doing. The hope then being that the player will then play his Character appropriately based off your description of the narrative as opposed to Meta-gaming and acting with the knowledge that the mage is asleep. This allows you to add atmosphere and context and provides for the player to understand your knowledge of the situation. If you do this though be consistent with all your players so the Paladin doesn't feel singled out in this regard. Most players don't realize they are meta-gaming when they are and often simply reintroducing the situation is enough to get them out of player mindset and back into their character's mindset.

If the player continues to meta-game after trying this, speak with them alone and indicate to them that what they are doing is inappropriate and ask that they try to resist acting on knowledge their character doesn't have. I personally have never had to go to this extent but most of my players are experienced gamers.

If all else fails remember this is a collaborative game that is intended to be fun for everyone yourself included.

  • \$\begingroup\$ Yes -- the question is about meta-gaming. About using out-of-characrer knowledge. If you remind "your character wouldn't know that" some players will stop and realize "oh, wow, you're right". Or maybe some other player will say "we just saw other monsters go to sleep -- obviously it got the wizard too" and feel smart. The thing is, this is really minor -- not like accidentally seeing the GM's buy a bunch of troll minifigs.. Letting it slide is an option. \$\endgroup\$ Commented May 28, 2020 at 15:24

Many great takes on this, especially the discussion on meta-gaming, but I think the other answers forget one key mechanic: Passive checks.

Real World-ish example (take with a grain of salt)

If I walked around a corner and saw someone on the ground. My eyes would quickly see no blood, chest rising and falling, and it's hot out. Diagnosis: passed out

If I walked around a corner and saw someone on the ground. My eyes quickly see a pool of blood, their hands on a place on their side, raspy breathing. Diagnosis: stabbed.

I could be wrong on either one of those. Maybe they are having a stroke in the first and were bitten by a dog in the second. The resolution, standing the corner, is the same.

Game Mechanic

First evaluate the passive checks. This takes into account what a PC could reasonably determine quickly, without a check, according to their best check.

What kind of DC should seeing a bleeding out, passed out, PC/NPC be? Very easy (5), Easy (10), medium (15)? These seem like easy checks at worst (opinion). Of course, determining if it's a magical sleep is hard to tell from just the facts at hand but would it change the PC action? Sleep is still reversible from a "shake or slap". That's as simple as a small kick and I would honestly rule that free to do as part of running up to the PC on the ground. A character with average wisdom (10) should be able to generally tell what is going on around them. Otherwise we'd have to roll skills checks just to walk through a doorway.

If they wanted to know more then they can spend their action to do more.

Additional Modifiers

What if their backstory is a doctor? Advantage on the DC.

What if they are a dunce of a barbarian... no applicable check. But wouldn't a barbarian see a pool of blood and know what was going on?


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