UP to half of primary school principals say they are on medication for conditions including blood pressure, depression, anxiety and sleep loss, amid growing concern about workplace stress.
An Irish Primary Principals' Network (IPPN) survey of 900 members made the finding after asking questions about work-related issues and medication.
IPPN director Sean Cottrell said principals' health was suffering from a growing workload arising from cutbacks and all the initiatives they have had to implement in recent years.
The IPPN has recently raised concerns about the impact of the principals' workload – and the knock-on effects on the quality of education – with the school management bodies and the Department of Education.
Mr Cottrell said: "Some of the most obvious effects of excessive workload include stress, leading to ill health, feelings of guilt, anxiety, depression and low job satisfaction.
"This has been confirmed by our survey, where nearly half report being on medication for various conditions including blood pressure, depression, anxiety and sleep loss."
Mr Cottrell said no matter how competent or confident a principal may be, "constant overload can erode their sense of self-worth to such an extent that some feel they can no longer cope".
He told his organisation's annual conference that he feared some principals were suffering in silence.
Among the other survey findings was one in five principals reporting more children coming to school hungry.
IPPN president Gerry Murphy said the issues that cropped up most often in the principals' responses included sleep loss, workload, weariness and lack of time with family.
He said principals also suffered from economic woes that affected all sectors of society.
Mr Cottrell said the administrative workload was also eating into time that could be better spent improving the educational experience of pupils.
He challenged the Government to reduce the red tape burden on principals and support school leadership in delivering strong education outcomes.
He said if there was to be a comparison of educational standards between countries, then the supports available must also be compared.
"Did you know that a teaching principal in Tyrone has one non-contact day every week? If you step across the Border to Donegal, his sister, doing the same job, is lucky to get one non-contact day every two-and-a-half weeks."
Mr Cottrell said in other countries, resources to employ administrators were ring-fenced, making sure that principals could focus on the quality of teaching and learning.
He urged the Government to prioritise funding for skilled administrators, reinstate in-school management posts, and allow at least one non-contact day per week for the leadership and management role of teaching principals.
And he asked for no further initiatives to be introduced unless schools got the necessary capacity to manage their implementation.
He said when workload affects the health of an employee, the employer, in their case the board of management, had a legal responsibility to act.