I get the impression that I don't understand How to Survive. The number of legitimate looking positive reviews indicates that whilst others have enjoyed the game I haven't.
The survival element from which the game takes it's name seems tacked on with little effect on game-play. In the hours I've played I've never come close to starving or dehydrating. A little message pops up telling you that you're becoming thirsty or hungry and that's solved by drinking or eating one of the many things in your inventory.
There are wells and bottles and canisters everywhere; I've haven't felt any tension or had to go on an epic quest to find water. There are also edible plants everywhere so whilst meat might not always be on the menu starving is not going to happen.
Sleeping is ... strange. There's no building or reinforcing shelters and no bedrolls or similar. There is one special shack per island that has a closeable door. That's the only place where you can sleep. If you're 51% tired you can't sleep but if you're 49% tired than you must. There's no wait command so sleeping through the night won't happen unless leave your character to get tired.
As survival games go there's no real element of survival in 'How to Survive'. Fallout 3 with Primary Needs or State of Decay will give you a much better experience.