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Evaluate the Workload: Determine whether your workload is CPU-bound or if there's a significant I/O component that could benefit from optimized reads. If your CPU is at 99.5% usage and you’ve optimized your queries and indexing, your workload might be CPU-bound rather than I/O-bound.
Vertical Scaling: Since Compute-optimized instances aren't available, you may consider scaling up within the memory-optimized family. Moving to a larger instance size within this family (e.g., db.r6g.4xlarge or higher) might provide the additional CPU resources you need.
Horizontal Scaling: If your workload allows, consider adding more read replicas. This can offload some of the read traffic, reducing CPU usage on the primary instance.
Serverless V2 Consideration: If your workload has fluctuating demand and you want to ensure CPU resources match demand, Serverless V2 could be an option. However, you would need to monitor it closely to ensure it meets your performance needs.
Database Optimization: Although you mentioned that the database and indexes are optimized, double-check for any long-running queries or tasks that might be consuming excessive CPU. Tools like AWS Performance Insights or native PostgreSQL tools can help identify such queries.
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