... I can't get 1 day without issues apparently...

When I was asleep, it looks like the database got stuck in some sort of optimize process with everything stuck waiting on that.

Restarting the database server forced that process to clear and cleaned things up.

I suspect what happened was I got overzealous after things started working great and I set the background worker count too high (these workers automatically run in the background doing things like updating contacts, downloading posts, etc).

I tuned that setting down, and increased the number of connections the database allows.