Game randomly freezes for 10-20 seconds every 30 mins or so

Same issue

Was having same issue on 5700x3D and Nvidia 4070ti Super. After I did this earlier today that pause screen has happened once over hours instead of every 20-30min. Right click the PathOfExileSteam.exe -> properties -> compatibility and change to Windows 7 for compatibility mode. Then download process lasso, while running the game open this up and find that executable in the list right click and cpu affinity -> always and then click 0 and 1. I had to go back to that thing twice to get them both. 120fps 4k working smooth the whole time with basically everything turned to max.

Supposedly some games have issues with 0/1 being used by games in Windows. Hope it helps at least someone. At least worth trying.

9800x3d
Rtx 4090

Had the same problem, game froze randomly for 10-15 seconds, sometimes in maps and sometimes in my ho.
Tried a few fixes and what actually worked was disabling Dlss and capping frames both in background and foreground (30/120).
Hope that helps someone

YuuuuuuuuuuuP

In the end, the only thing that solves it for me is switching to Vulkan which means less fps. I initially just stuck with DX12 and dealt with the issue (pressing escape as soon as the screen freezes makes it feel less "panicky" since the game pauses when shaders reload), but now I just decided to go with Vulkan and lower settings. Bit shitty, but sadly I don't see any fix in the horizon.