Running a modern school may increasingly be like managing a business, complete with multi-million pound budgets to juggle and targets to meet.
But when the stresses faced by headteachers are compared with those of business managers, a clear difference emerges: the people who run the schools have it far tougher.
Asked if the demands on them have endangered their health, 45 per cent of heads agreed, compared with 35 per cent of managers and other professionals.
Heads were also a third more likely than counterparts in equivalent senior jobs to say their work left them too tired for sex and that they did not see their children as often as they liked.
The findings come from a report by Keele university's centre for industrial relations, published today by the National Association of Head Teachers.
The centre surveyed 688 association members for another study published earlier this year, then put the same questions to 1,654 senior employees in managerial and professional occupations and compared responses.
It found a few categories where heads seemed happier than other managers.
They were slightly more likely to say they found their work very rewarding, and significantly less likely to complain that their jobs were insecure or their working relationships poor.
But the report concluded: "The most striking finding to emerge is the significantly worse position that headteachers find themselves in, compared to other professional and managerial workers.
"The responses indicate higher levels of stress and stress-related ill-health, affecting not only the teachers themselves, but having a negative and potentially long-lasting impact on the efficient running of schools, breaking down relationships with colleagues and parents and leading to costly mistakes. These findings are extremely disturbing for the future of school leadership."
More than four-fifths of headteachers felt their workload had increased over the previous year, while only half of their counterparts in business felt the same.
One key cause for headteachers' stress appears to be bureacracy. Two-thirds of heads said that "less red tape" would be the biggest improvement to their jobs, as compared with fewer than half of the other managers.
Mick Brookes, general secretary of the association, said: "Everything we have been saying about the incessant stress on headteachers appears to be spot-on. The impact it shows on heads' family lives reminds me of a headteacher's husband I met. He said he looked forward to the third week in August because 'That's when I get my wife back'."
Work-life balance of managers, professionals and headteachers is at www.naht.org.uk