Climacteric is related to an increase in sleep disturbances, especially insomnia symptoms, which are linked with poorer quality of life, adverse physical and mental health, reduced productivity, and increased healthcare costs. Vasomotor symptoms are a key component of sleep disruption in climacteric, although other symptoms, like depressive symptoms, or challenges in life often contribute to sleep disorders. Findings from polysomnographic studies are less consistent in showing disrupted sleep in climacteric. Menopausal hormone therapy alleviates subjective sleep disturbances, particularly if vasomotor symptoms are present. However, due to contraindications and adverse effects, other options should also be considered; especially results from cognitive behavioral therapy are positive. Given that climacteric symptoms may persist for several years, consideration, prevention, and treatment of climacteric sleep disturbances are essential in order to ensure better health, quality of life, and work productivity in midlife women.