The BCG CEO Insomnia Index: Understanding CEO Pressure

How Intense is CEO Pressure Right Now?

When asked to rate their overall job-related stress over the last quarter on a scale from 0 (no stress) to 100 (extreme stress), CEOs averaged a rating of 66.7 out of a possible 100—above the clinical threshold typically used to indicate high stress. It’s an aspect of the job that transcends geography: CEOs throughout the world report similarly high stress levels.  

Our research suggests that when CEOs perceive their workload as unsustainable, they reach a tipping point where high stress becomes nearly unavoidable, setting them on a path toward burnout. This dynamic can have significant repercussions for leaders’ personal health and for the organizations they lead. Making consistent, high-quality decisions in complex, high-stakes environments is a fundamental requirement of the CEO role, but chronic stress erodes the cognitive functions those decisions depend on—attention, memory, and problem solving—ultimately leading to poorer decision quality.¹ 1 Marcus Selart and Svein Tvedt Johansen, “Ethical Decision Making in Organizations: The Role of Leadership Stress,” Journal of Business Ethics 99, no. 2 (2011): 129–43; Kubilay Gok and Nuray Atsan, “Decision-Making under Stress and Its Implications for Managerial Decision-Making: A Review of Literature,” International Journal of Business and Social Research 6, no. 3 (2016): 38–47.

Stressors and Stakeholders: What’s Driving CEO Pressure

Insights from BCG’s CEO Insomnia Index

• Relentless performance demands drive CEO pressure. Hitting growth targets and managing costs top the list of CEO stressors. Few see relief in sight, with more than half of leaders (60%) expecting operating conditions to remain “challenging” or “very challenging” in the months ahead.
• AI feels energizing today, but the ROI clock is ticking. AI does not rank among the top CEO stressors, but each AI announcement that leaders make raises market expectations and compresses the timeline to deliver measurable results.
• Heightened board scrutiny intensifies CEO pressure. One in three CEOs say they have more to prove to their boards now than they did just six months ago.
• For many CEOs, pressure stems from their own teams. CEOs of companies with revenues over $5 billion rank their senior leadership team as their most stressful stakeholder, and they view their chief financial officer (CFO) as the biggest threat to their job security.
• Near-term pressures are dominating CEOs’ time. More than half of CEOs (57%) say near-term issues consume an outsized share of their time.
• As immediate pressures dominate, CEO turnover risks can go unnoticed. Shareholder activism and rising employee disgruntlement rank low among CEO stressors despite being significant drivers of CEO turnover risk.

What the Index Reveals About CEO Pressure, CEO Turnover, and CEO Burnout

What leads to CEO turnover?

Our CEO Job Security Model uses a logistic regression approach to explore the likelihood of CEO turnover. The model’s dependent variable is actual CEO exits from the S&P 1200 over the past five years, which we use to predict the likelihood of CEO turnover in the next quarter. The model also uses independent variables including employee net entry rate, sentiment analysis based on earnings call data from BCG’s CEO Data Point Interactive, negative media mentions, total shareholder return, and more.

Is CEO turnover accelerating? And if so, why?

Yes, CEO turnover is accelerating. The reasons are varied:

• Some departures are planned years before a CEO steps down. When done well, succession planning can help cement a CEO’s legacy.
• Not all exits are planned. Some CEOs are forced out of the C-suite by shareholder activists, a reputational crisis, performance misses, or a loss of board confidence.
• CEO burnout is also on the rise.

By focusing on turnover risk factors more within a CEO’s control, the BCG CEO Insomnia Index helps leaders understand what drives stress in the role—and how to safeguard their physical and mental well-being, avoid CEO burnout, and better cope with the isolation that can come with the job.

What does executive burnout look like?

According to the World Health Organization, burnout is a syndrome caused by chronic workplace stress that hasn’t been effectively managed. It is marked by exhaustion or depleted energy, growing detachment or cynicism toward work, and a reduced sense of professional effectiveness.

Drawing on two proprietary sources—a survey of approximately 500 CEOs from leading companies and BCG’s CEO Job Security Model—the BCG CEO Insomnia Index moves beyond defining burnout to analyze what’s driving CEO stress and offer practical guidance for managing it.

What do CEOs struggle with most?

Balancing short-term pressures with long-term strategy is among the most common struggles identified by the BCG CEO Insomnia Index. More than half of CEOs responding to the survey said near-term issues often take up too much of their time and attention. Many also described the role as profoundly isolating, citing boards, employees, and senior leadership teams as their most stressful stakeholders. As one leader put it, the CEO is an “emotional shock absorber.”