Background <p>Sleep disorders are highly prevalent among hemodialysis patients and may adversely affect psychological well-being, life satisfaction, and meaning in life. However, limited research has examined the moderating roles of life satisfaction and meaning in life in the relationship between sleep quality and psychological symptoms. This study aimed to investigate whether life satisfaction and meaning in life moderate the associations between sleep quality and stress, anxiety, and depression in hemodialysis patients.</p> Methods <p>This descriptive, correlational study included 110 hemodialysis patients. Data were collected through face-to-face interviews using the Pittsburgh Sleep Quality Index (PSQI), Depression-Anxiety-Stress Scale-21 (DASS-21), Life Satisfaction Scale (LSS), and Meaning in Life Scale (MLS). Data were analyzed using correlation, multivariate regression, and moderation analyses.</p> Results <p>Higher PSQI scores (indicating poorer sleep quality) were positively correlated with stress (<i>r</i> = 0.41, <i>p</i> &lt; 0.05), anxiety (<i>r</i> = 0.32, <i>p</i> &lt; 0.05), and depression (<i>r</i> = 0.32, <i>p</i> &lt; 0.05). Life satisfaction significantly moderated the relationship between stress and sleep quality (β = −0.041, <i>p</i> = 0.024), indicating a buffering effect. However, meaning in life did not show a significant moderating role in the relationships between sleep quality and psychological symptoms.</p> Conclusion <p>Higher stress, anxiety, and depression were associated with poorer sleep quality in hemodialysis patients. Life satisfaction buffered the negative effect of stress on sleep, whereas meaning in life showed no moderating role. Interventions targeting life satisfaction may help improve sleep quality and psychological well-being.</p>