It sounds like you've hit the postgres basics, what about some of the linux
check list items?

what does free -m show on your db server?

If the load problem really is being caused by swapping when things really
shouldn't be swapping, it could be a matter of adjusting your swappiness -
what does cat /proc/sys/vm/swappiness show on your server?

There are other linux memory management things that can cause postgres and
the server running it to throw fits like THP and zone reclaim.  I don't
have enough info about your system to say they are the cause either, but
check out the many postings here and other places on the detrimental effect
that those settings *can* have.  That would at least give you another angle
to investigate.

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