BACKGROUND Sleep deprivation would result in sleepiness during learning activities, with impairment of cognitive abilities and psychological wellbeing. Medical training, with its immense workload in a highly stressful environment, makes students especially vulnerable to poor sleep. This study evaluated the impact of sleep quality and related factors on academic performance in medical students of first academic year. METHODS This is a cross sectional study. 138 students in the first academic year of MBBS course in Govt. Medical College, Kottayam were enrolled as the study group. Assessment of sleep quality was based on scores of Pittsburgh Sleep Quality Index [PSQI]. Epworth Sleepiness Scale [ESS], a validated self-reported questionnaire, was used to assess excessive daytime sleepiness. Internal assessment marks scored by each student in the examinations conducted within 30 days prior to filling the questionnaire, was used to examine the relationship between academic performance, sleep quality and daytime sleepiness. RESULTS Quality of sleep was assessed both subjectively and objectively. It did not show statistically significant association with level of academic performance of the students. Significant association was found between sleep disturbance and level of academic achievement. Majority of students with good academic performance were found to have normal day time sleepiness, although the association was not statistically significant. CONCLUSIONS Sleep deprivation adversely affects the academic performance of medical students of first academic year. Awareness regarding good sleep hygiene need to be created among students at the institutional level.