Investigating stress dynamics triggers and sleep disturbances among Indian medical students

India’s medical education system, marked by a surge in seats from 51,000 to 108,000 (2014–2024), has intensified competition, fuelling a mental health crisis among undergraduate medical students. This multicentric, cross-sectional study (January–June 2024) examined stress dynamics, triggers, and sleep disruptions in 625 medical students across two institutes: Institute-A (n = 385, Uttar Pradesh) and Institute-B (n = 240, Raipur). Employing the Perceived Stress Scale and Modified Sleep Disorders Questionnaire, we assessed stress levels, sleep disturbances, and help-seeking behaviours. Using R-software version 4.5.0. Findings revealed 55.5% of students faced moderate stress, 13.6% high stress, and 18.9% severe insomnia, with Institute-B showing significantly elevated stress (17.9% vs. 10.9%, p = 0.011) and insomnia (25.0% vs. 15.1%, p = 0.002). Academic pressure (56.8%) and exam stress (61.3%) were predominant triggers, while circadian rhythm disorders affected 34.4%. Only 41.2% of high-stress and 41.5% of severe insomnia students sought consultation, underscoring stigma and access barriers. Institute-B’s higher burden suggests academic and environmental influences. This study unveils a silent epidemic, urging institutions to adopt mandatory stress management, sleep hygiene programs, and stigma-free counselling to protect India’s future healthcare workforce and address rising dropout and suicide risks.