>North American (NA) schools have bullying, exams, homework, and sleep disruption but our system is still relatively intact.
My impression from living here in Japan for a bit over a year, and having friends with children in the Japanese school system, is that Japanese students have way more pressure put on them. Kids spend way longer each day out of the house; Study sessions before school, stronger peer pressure to assimilate and not stick out, more after school activities, more homework to do in the evenings, school six days a week. Also keep in mind that the middle school you get into will have a huge effect on which high school you get to attend, which has a very strong influence on which college you get into, and thus effect your pipeline into the best companies. The pressure to succeed starts way younger than it does in the US, and not getting into the primary school of choice can ruin your chances for success later on in adult hood.
A couple of anecdotal stories I've seen during my time here; Bullying here seems to be much more pronounced, and given the cultural hesitation to involve yourself in other's affairs, often goes unchecked. I've seen many instances of large groups of 10+ kids ganging up on a single kid on the streets, in full view of adults and even public safety volunteers, and no one will ever step in and tell the kids to stop.
On another occasion I was outside of a combini having a drink, and near by a young girl (maybe 8 years old or so), was crying trying to do her homework. The mother was nearby and when she would write down answers that were wrong, the mother would scream at the child and call her stupid, which would cause the child to cry harder (but still trying to complete her work), and the entire thing just kind of created this negative feedback loop - child would cry harder and probably do worse on the work, which would anger the mother and make the screaming more intense, which caused the crying to become more intense. It was a really depressing and disturbing thing to witness, especially given the young age of the child.
I know bullying exists in the west (myself being a victim of some pretty intense bullying as a child), and there is strong pressure to do well in high school to get into the best colleges as well, but from what I've seen in Japan it seems to be much more pronounced. At least in the west most times an adult will step in to stop bullying when it's seen, but here it seems no one cares or will do anything to stop it.