Ok you want an idea for a level, Sadly I don't have much ideas for the level of what you're making, except an item.
How about an item for that level, a simple dice, Although not much, one roll and if it lands on a number for example "6", it either spares you, or harm you. The spare and harm are randomized for each number, so you must have to be lucky. If 6, you either get harmed 6 times brutally, or either get spared, with 6 rashones for you to survive with. This is the same for all numbers, but they have their own items for spares.
Try to leave the dice anywhere, it'll be within your pocket again, no way to remove the item for 7 months. And once it reaches 7 months, it'll then disappear within your pocket. Trying to not interact with the item for days on end would drain your sanity, so you must play with the dice.