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I've been looking over the rules about heatstroke (Heat Dangers, p.444) and I think they're mostly realistic, IF you assume that the creatures aren't staying hydrated.
My thinking is that once a character starts taking nonlethal damage from heat, they can recover 1 point of nonlethal heat damage per quart of water they drink, and avoid the fatigue effect. (My PCs cleric and druid both prepare create water each day during their overland desert journeys, so the party has ready access to lots of water.)