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It makes you a lot more cautious than you would on the normal difficulty, and choose combat more carefully.
The biggest issue will be the radiation if you can't find a reliable pure water source (or use a bottling mod) and the weight for water and mostly ammo if you are the shoot-on-sight type.
I only said that Hardcore mode is not as frightening as most new players think it is (or how big the intro text there makes it to be). More than likely the biggest issue you'll have is the limited ammo space, especially if you are fond of the Anti-Materiel rifle or the big guns, the ammo for those is particularly heavy.
Think it as like the "need to eat" thing that was introduced in GTA San Andreas. It was rarely a hassle but the fact that it was there was enough to keep you on your toes.
Nope.
Sleeping does regen health, even 1 hour of sleep is enough to fill your health bar.
Limb condition also recovers to full when sleeping, assuming you didn't break your limbs.
Ikr, who wants rp elements and enjoyable characters in their rpg?