Restless legs and insomnia in the third trimester
Restless legs and insomnia are both common by the third trimester of pregnancy. Learn why they happen, what's safe to try, and when to call your doctor.
In short
Restless legs (a strong urge to move your legs, often worse at night) and trouble sleeping both get more common by the third trimester. Both usually go back to normal after you give birth. Getting up to walk or stretch when the urge hits is safe to try tonight. So is sleeping on your left side with a pillow between your legs. Call your doctor if lost sleep is affecting your ability to function during the day.
Sourced from StatPearls (NCBI Bookshelf, NIH), PMC (NIH) - Restless legs syndrome and pregnancy: A review, Cleveland Clinic · Updated August 15, 2026
Your legs may have started buzzing, twitching, or aching the moment you lie down. Sleep may feel like it's slipping further away every week. You are not imagining it, and you're not doing anything wrong. Restless legs syndrome (RLS) and insomnia both tend to get worse in the third trimester. They often arrive together, and both have real physical explanations behind them.
This isn't a case of "just relax" or "try counting sheep." RLS affects an estimated 11% to 29% of pregnant women. By the third trimester, it climbs to around 23%, up from close to 0% before pregnancy. Meanwhile, up to 80% of women report insomnia by the end of the third trimester. Here's what's actually happening in your body. Here's what's safe to try, and what's worth flagging to your provider.
Why do restless legs get worse now?
Pregnancy raises your risk of restless legs syndrome (RLS). That risk climbs with each trimester. Among pregnant women who get it, the rate rises steadily and peaks in the third trimester at about 23%, up from close to 0% before pregnancy. So if this feeling is new right now, that timing is typical, not unusual.
The cause isn't a total mystery, either. RLS is believed to involve a problem in the brain's dopamine system (a chemical that controls movement). Lower iron stores in certain brain areas play a part too. That's a real, measurable body process, not just vague "pregnancy discomfort." There's good news too. RLS that starts during pregnancy usually goes away after delivery. In one review, symptoms disappeared within a few days of giving birth in about 97% of women who had it.
What does it actually feel like?
RLS has a recognizable pattern that helps set it apart from ordinary pregnancy leg discomfort. Symptoms usually get worse toward the end of the day and are worst at night. They often show up within just 15 to 30 minutes of lying down, right when you're trying to fall asleep.
Here's one detail that can bring real, right-now relief. Walking or stretching your legs can partly or fully relieve the urge to move them. That's not a folk remedy. It's a documented feature of the condition itself. That's why getting up and moving, even briefly, so often helps more than lying still and trying to wait it out.
Could it be a nutrient issue?
A twitchy, restless feeling in your legs during pregnancy can sometimes point to low folate (a B vitamin your body needs more of during pregnancy). This doesn't mean you should self-diagnose or start changing supplements on your own. It does mean the feeling is worth describing to your provider in detail. Tell them when it starts, what it feels like, and what helps. Then they can check your nutrient levels alongside the dopamine and iron factors already at play.
Why is sleep so hard even without restless legs?
Even without RLS, sleep gets harder to find late in pregnancy. Up to 80% of women report trouble sleeping by the end of the third trimester. The weight of your growing baby is usually the main reason for this insomnia. That's why sleep problems tend to get worse in these final weeks rather than staying steady the whole time.
When restless legs and this weight-related insomnia overlap, it can feel like there's no comfortable way to lie down at all. Knowing that both have separate causes can take away the sense that something is uniquely wrong with you. This overlap is common and well documented in late pregnancy.
What can I safely try tonight?
Start with your sleep position. One recommended position for pregnancy insomnia is sleeping on your left side with a pillow between your legs. It's a small change that can ease both the physical weight causing insomnia and general nighttime discomfort.
For the restless, crawly feeling itself, use the one relief method that's actually documented. Get up and walk, or stretch your legs, when the urge hits. Don't just try to lie still and wait it out. Since symptoms tend to show up within 15 to 30 minutes of lying down, a short walk or stretch before bed may help you get ahead of the worst of it.
On medication, the clearest guidance is what to avoid. Opioids (strong prescription pain medicines) should be avoided if possible for treating RLS during pregnancy. Beyond that, any supplement or medication decision, including anything about folate or iron, belongs in a conversation with your provider. They can weigh it against your own labs and history.
When should I call my doctor?
Most restless-leg and insomnia symptoms in the third trimester are uncomfortable, not risky. They tend to go away on their own after delivery. But there's one clear line to watch for. Tell your healthcare provider if lost sleep is affecting your ability to function during the day. Struggling to concentrate, stay alert, or get through your day because of lost sleep is the signal. It means this has moved from "exhausting but expected" to something your provider should actively help you manage, not something to just wait out.
Frequently asked questions
Will restless leg syndrome go away after I give birth?
In most cases, yes. Restless legs syndrome that develops during pregnancy usually goes away after delivery. Research following pregnant women with the condition found that symptoms disappeared within a few days of giving birth in about 97% of cases. If your legs are keeping you up now, it's reasonable to expect real relief on the other side.
Am I the only one dealing with this, or is it actually common?
You're in very good company. Restless legs syndrome affects an estimated 11% to 29% of pregnant women overall. Pregnancy itself is a recognized risk factor, and the odds rise in each trimester. Among pregnant women who develop the condition, the rate climbs across pregnancy and peaks in the third trimester at around 23%, up from essentially 0% before pregnancy. Insomnia is just as widespread by this point. Up to 80% of women report symptoms by the end of the third trimester.
What's actually causing the restless, crawly feeling in my legs?
Restless legs syndrome is believed to involve a problem in the brain's dopamine system, along with lower iron stores in specific brain regions. A twitchy, restless feeling in the legs during pregnancy can also point to low folate intake, a nutrient your body needs more of right now. Your prenatal provider can actually check both of these. It's worth mentioning the sensation at your next visit rather than assuming it's just something to push through.
Is it safe to take something for restless legs while I'm pregnant?
Any medication decision during pregnancy should go through your provider, not a general list. What is clearly established is that opioids should be avoided, if possible, for treating restless legs syndrome symptoms during pregnancy. Non-medication approaches are the safest starting point: walking, stretching, and addressing nutrient intake with your provider's guidance. Your provider can talk through anything further if those aren't enough.
When does third-trimester sleep trouble stop being 'normal' and become something to flag?
Restless legs and pregnancy insomnia are expected experiences for most women late in pregnancy, not signs that something is wrong on their own. But you should tell your healthcare provider if lost sleep is affecting your ability to function during the day. That's the line worth paying attention to. It's not about how many nights you've had trouble sleeping. It's about whether it's catching up with you when the sun is up.
Sources
- Restless legs syndrome symptoms typically worsen toward the end of the day and are at their worst at night, often appearing within 15 to 30 minutes of lying down in bed. — StatPearls (NCBI Bookshelf, NIH)
- The urge to move the legs in restless legs syndrome can be partially or completely relieved by walking or stretching the legs. — StatPearls (NCBI Bookshelf, NIH)
- Restless legs syndrome is believed to involve a dysfunction in the brain's dopamine system along with diminished iron stores in specific brain regions. — StatPearls (NCBI Bookshelf, NIH)
- Restless legs syndrome affects an estimated 11% to 29% of pregnant women. — StatPearls (NCBI Bookshelf, NIH)
- Restless legs syndrome that develops during pregnancy usually goes away after delivery. — StatPearls (NCBI Bookshelf, NIH)
- In pregnant women with restless legs syndrome, prevalence rises across pregnancy and is highest in the third trimester, reaching about 23% (up from 0% before pregnancy). — PMC (NIH) - Restless legs syndrome and pregnancy: A review
- After delivery, restless legs syndrome symptoms disappear within a few days in about 97% of affected women. — PMC (NIH) - Restless legs syndrome and pregnancy: A review
- Opioids should be avoided, if possible, for treating restless legs syndrome symptoms during pregnancy. — PMC (NIH) - Restless legs syndrome and pregnancy: A review
- Pregnancy is a recognized risk factor for restless legs syndrome, and the risk increases with each trimester. — Cleveland Clinic
- A twitchy, restless feeling in the legs during pregnancy may signal insufficient folate intake, a nutrient the body needs more of during pregnancy. — Cleveland Clinic
- The weight of the growing fetus is usually the main reason for insomnia toward the end of pregnancy. — Cleveland Clinic
- One recommended sleep position for pregnancy insomnia is sleeping on the left side with a pillow placed between the legs. — Cleveland Clinic
- Up to 80% of women report insomnia symptoms by the end of the third trimester of pregnancy. — Cleveland Clinic
- Pregnant women should tell their healthcare provider if sleep deprivation is affecting their ability to function during the day. — Cleveland Clinic
Educational information, not medical advice — always consult your doctor.