More than 70% of chief executives are experiencing clinically high levels of stress, with most of their anxiety focused on near-term growth targets, costs, and pressure from their boards, according to a new report from Boston Consulting Group, CEO Insomnia Index: Understanding CEO Pressure.

Why it matters: While CEOs are consumed by daily operational pressures, the inaugural BCG CEO Insomnia Index suggests they may be overlooking the very threats most likely to end their careers, including shareholder activism and employee attrition.

By the numbers: The study, which surveyed 500 CEOs and analyzed five years of S&P 1200 turnover data, found:

  • The average CEO job-related stress score was 66.7 out of 100, above the threshold for clinically high stress.
  • Boards of directors were ranked as the most stressful stakeholder group, followed by employees.
  • For CEOs at the largest companies ($5 billion+), their own senior leadership team was the single biggest source of stress.
  • When asked which C-suite member poses the biggest risk to their job security, CEOs most frequently named their chief financial officer (CFO).
The big picture: The findings paint a picture of an isolated and demanding role, with one CEO describing the job as being an "emotional shock absorber." This pressure is intensifying as boards become more knowledgeable on complex topics like AI and geopolitics, leading to more granular scrutiny.

  • One in three CEOs said they have more to prove to their boards now than they did six months ago.
  • 60% expect operating conditions to be "challenging" or "very challenging" in the coming months.
Zoom in: The blind spots: The report identifies a significant disconnect between what CEOs worry about and what the data shows are major risks to their job security.

  • Shareholder activism: CEOs ranked this as their least stressful challenge. However, BCG's model finds that when a company is targeted by activists, the likelihood of CEO turnover increases by 24%.
  • Employee discontent: Fewer than half of CEOs are concerned about rising employee disgruntlement. But a 10% drop in a company's "employee net entry rate" increases the likelihood of a CEO exit by 12%.
  • Artificial intelligence: AI is not a top-five stressor, as most CEOs view it as an opportunity. However, only 28% feel high urgency from stakeholders to deliver bottom-line value from AI in the next six months, a number that jumps to 42% at larger firms, suggesting a reckoning is coming.
Between the lines: The stress is often coming from inside the house. The fact that senior leadership teams are a top stressor helps explain why more than half of CEOs surveyed plan to make changes to their top team within the next six months.

What to watch: The report suggests that CEOs who remain fixated on short-term performance pressures may be vulnerable to being blindsided by longer-term, structural threats. The growing gap between perceived stress and data-driven risk could foreshadow a new wave of leadership instability.

View BCG's CEO Insomnia Index: Understanding CEO Pressure here.

SOURCE: BCG

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