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So I've searched high and low but can't really find a definitive answer for this.
Rules for drowning are pretty straightforward. My question is what if someone were choking you while holding your head under water? Obviously this would require a grapple, and possible a pin. But would this increase the DC of the check vs drowning or shorten the duration for which one can hold their breath? Obviously the stress from the grapple and the struggle would consume more oxygen per a logical standpoint, but is there a rule out there for this kind of thing?
Would require a pin, a grappled foe is still standing and not at your mercy.
And no rules for holding breath apply as normal. Who's to say the victim being heroic doesn't panic in such situations and bides their time until they can break the pin and take a breath.
there are endless "logical" special mechanics you could include to make combat more true to life but that just results in a bloated combat system that too complicated to run efficiently.
EDIT****
had another thought on this when your talking strangulation people usually pass out because the blood supply to their brain is cut off (constricting the major arteries in the neck to the head), the classic sleeper hold. Of course if you keep strangling this will result in death.
I could potentially see the sleeper hold as a specific feat requiring a combat maneuver.
At best this would be a house rule.
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The standard rules on drowning (Core book page 445) state that taking standard or full-round actions halves the length of time you can hold your breath - so a struggling character drowning faster Vs a placid character is already covered.
The garrotte (Adventurer's Armory page 3) allows you to apply choking to a grapple.