Don't Rest Your Head

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DRYH for short. DRYH is an RPG by Evil Hat where players take on the role of people who haven't slept for so long they have "awakened" to the Mad City and the Nightmares that live there. The game uses pools of d6 dice, with the players rolling attributes such as Madness, Discipline and Exhaustion while the GM rolls Pain dice.

It is fairly rules-light, with the GM using Pain dice for every obstacle the players have to overcome, the author even recommending that the dice only be rolled when something significant is at stake and that the protagonists automatically succeed at all other tasks. It also lacks any system for keeping track of physical injury, instead having boxes for Permanent Madness and Exhaustion. Of course, both those things will kill you (or turn you into an evil NPC) once you accumulate enough of them, and happen to be extremely difficult to get rid of.

DRYH is also made of fuckwin, as a typical session might include using a voodoo teddy bear to cause a massive traffic accident, summoning legions of cannon fodder ninjas to beat up a mob of clockwork cops, or dropkicking the incarnation of death into the depths of hell itself. There's even a Madness Talent (read: insomnia super power) that allows you to turn into Jesus Christ himself, complete with the water-walking, fish-multiplying and absolution powers.

Despite the fact that the players can kick the ass of pretty much anything in the entire setting from day one, the most important thing to remember is that since most of the negative effects the players can suffer are more or less permanent and become more frequent the more of them they accumulate, they're pretty much doomed to eventually either fall asleep and get gang-raped by the Nightmares living in the Mad City or go batshit insane and become one of them.