diff --git a/changelog.d/12747.bugfix b/changelog.d/12747.bugfix
new file mode 100644
index 0000000000..0fb0059237
--- /dev/null
+++ b/changelog.d/12747.bugfix
@@ -0,0 +1 @@
+Fix poor database performance when reading the cache invalidation stream for large servers with lots of workers.
diff --git a/synapse/storage/databases/main/cache.py b/synapse/storage/databases/main/cache.py
index dd4e83a2ad..1653a6a9b6 100644
--- a/synapse/storage/databases/main/cache.py
+++ b/synapse/storage/databases/main/cache.py
@@ -57,6 +57,14 @@ class CacheInvalidationWorkerStore(SQLBaseStore):
self._instance_name = hs.get_instance_name()
+ self.db_pool.updates.register_background_index_update(
+ update_name="cache_invalidation_index_by_instance",
+ index_name="cache_invalidation_stream_by_instance_instance_index",
+ table="cache_invalidation_stream_by_instance",
+ columns=("instance_name", "stream_id"),
+ psql_only=True, # The table is only on postgres DBs.
+ )
+
async def get_all_updated_caches(
self, instance_name: str, last_id: int, current_id: int, limit: int
) -> Tuple[List[Tuple[int, tuple]], int, bool]:
diff --git a/synapse/storage/schema/main/delta/69/02cache_invalidation_index.sql b/synapse/storage/schema/main/delta/69/02cache_invalidation_index.sql
new file mode 100644
index 0000000000..22ae3b8c00
--- /dev/null
+++ b/synapse/storage/schema/main/delta/69/02cache_invalidation_index.sql
@@ -0,0 +1,18 @@
+/* Copyright 2022 The Matrix.org Foundation C.I.C
+ *
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ * http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ */
+
+-- Background update to clear the inboxes of hidden and deleted devices.
+INSERT INTO background_updates (ordering, update_name, progress_json) VALUES
+ (6902, 'cache_invalidation_index_by_instance', '{}');
|