We've been dealing with this exact same problem for months now. We have a support case open with Microsoft, but everything we've tried has lead to no improvement whatsoever.
Every time something did look as though it had helped: after the reboot it would be fine for a few days, but then it would start happening again. The frustrating thing is we have another identical(!) server which has never ever had the issue.
In the sql server log I can definitely see intriguing patterns, but I can't understand them.
The most evident pattern is in the Duration field of the log entry: this is an excerpt of a few days:
2007-09-23 00:12:37.47 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 0 seconds. Working set (KB): 383800, committed (KB): 11801760, memory utilization: 3%.
2007-09-23 00:18:09.18 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 331 seconds. Working set (KB): 2651432, committed (KB): 11801760, memory utilization: 22%.
2007-09-23 00:23:37.09 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 659 seconds. Working set (KB): 1403452, committed (KB): 11801760, memory utilization: 11%.
2007-09-23 00:27:59.09 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 921 seconds. Working set (KB): 2243196, committed (KB): 11801760, memory utilization: 19%.
2007-09-23 00:33:28.61 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1251 seconds. Working set (KB): 1989840, committed (KB): 11801760, memory utilization: 16%.
2007-09-23 00:37:50.93 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1513 seconds. Working set (KB): 3573024, committed (KB): 11801760, memory utilization: 30%.
2007-09-23 00:43:18.83 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1841 seconds. Working set (KB): 5002408, committed (KB): 11801640, memory utilization: 42%.
2007-09-23 00:50:24.71 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 0 seconds. Working set (KB): 61060, committed (KB): 11806568, memory utilization: 0%.
2007-09-23 00:55:52.64 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 327 seconds. Working set (KB): 3041964, committed (KB): 11801640, memory utilization: 25%.
2007-09-23 01:01:20.57 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 655 seconds. Working set (KB): 1319536, committed (KB): 11804840, memory utilization: 11%.
2007-09-23 01:05:42.90 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 918 seconds. Working set (KB): 1527424, committed (KB): 11804968, memory utilization: 12%.
2007-09-23 01:11:10.83 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1246 seconds. Working set (KB): 2394260, committed (KB): 11804848, memory utilization: 20%.
2007-09-23 01:15:33.16 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1508 seconds. Working set (KB): 1438816, committed (KB): 11804848, memory utilization: 12%.
2007-09-23 01:21:01.09 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1836 seconds. Working set (KB): 1953928, committed (KB): 11804848, memory utilization: 16%.
2007-09-23 01:50:31.87 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 3607 seconds. Working set (KB): 4497384, committed (KB): 11801776, memory utilization: 38%.
2007-09-23 02:50:38.82 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 7213 seconds. Working set (KB): 2121912, committed (KB): 11802288, memory utilization: 17%.
2007-09-23 04:50:55.44 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 14430 seconds. Working set (KB): 845800, committed (KB): 11800624, memory utilization: 7%.
2007-09-23 08:50:29.00 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 28803 seconds. Working set (KB): 2151876, committed (KB): 11804888, memory utilization: 18%.
2007-09-23 16:51:24.58 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 57659 seconds. Working set (KB): 2861464, committed (KB): 11804888, memory utilization: 24%.
2007-09-23 18:44:30.17 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 0 seconds. Working set (KB): 23772, committed (KB): 11805216, memory utilization: 0%.
2007-09-23 18:49:58.08 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 327 seconds. Working set (KB): 1874064, committed (KB): 11805280, memory utilization: 15%.
2007-09-23 18:55:26.00 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 655 seconds. Working set (KB): 2500840, committed (KB): 11805344, memory utilization: 21%.
2007-09-23 18:59:48.33 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 918 seconds. Working set (KB): 2828416, committed (KB): 11805344, memory utilization: 23%.
2007-09-23 19:05:16.23 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1246 seconds. Working set (KB): 3701268, committed (KB): 11805592, memory utilization: 31%.
2007-09-23 19:09:38.54 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1508 seconds. Working set (KB): 1377936, committed (KB): 11805592, memory utilization: 11%.
2007-09-23 19:15:06.47 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1836 seconds. Working set (KB): 2118884, committed (KB): 11805472, memory utilization: 17%.
2007-09-23 19:44:37.16 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 3606 seconds. Working set (KB): 3115628, committed (KB): 11805600, memory utilization: 26%.
2007-09-23 20:44:49.95 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 7219 seconds. Working set (KB): 859280, committed (KB): 11806360, memory utilization: 7%.
2007-09-23 22:45:03.81 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 14433 seconds. Working set (KB): 1673520, committed (KB): 11806424, memory utilization: 14%.
2007-09-24 00:51:26.30 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 0 seconds. Working set (KB): 225768, committed (KB): 11812120, memory utilization: 1%.
2007-09-24 00:56:54.21 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 327 seconds. Working set (KB): 3119180, committed (KB): 11806496, memory utilization: 26%.
2007-09-24 01:02:22.12 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 655 seconds. Working set (KB): 1573036, committed (KB): 11809696, memory utilization: 13%.
2007-09-24 01:06:44.46 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 918 seconds. Working set (KB): 2740832, committed (KB): 11809696, memory utilization: 23%.
2007-09-24 01:12:12.43 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1246 seconds. Working set (KB): 1614560, committed (KB): 11809456, memory utilization: 13%.
2007-09-24 01:16:34.75 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1508 seconds. Working set (KB): 2009292, committed (KB): 11809456, memory utilization: 17%.
2007-09-24 01:22:02.66 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1836 seconds. Working set (KB): 2493024, committed (KB): 11809456, memory utilization: 21%.
2007-09-24 01:51:33.55 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 3607 seconds. Working set (KB): 4742328, committed (KB): 11809712, memory utilization: 40%.
2007-09-24 02:51:40.72 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 7214 seconds. Working set (KB): 922168, committed (KB): 11806768, memory utilization: 7%.
2007-09-24 04:51:54.16 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 14428 seconds. Working set (KB): 1038548, committed (KB): 11806064, memory utilization: 8%.
2007-09-24 08:51:30.10 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 28803 seconds. Working set (KB): 1764916, committed (KB): 11812656, memory utilization: 14%.
2007-09-24 16:51:33.44 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 57606 seconds. Working set (KB): 1738296, committed (KB): 11814320, memory utilization: 14%.
2007-09-24 18:37:50.39 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 0 seconds. Working set (KB): 88856, committed (KB): 11815008, memory utilization: 0%.
2007-09-24 18:43:18.38 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 327 seconds. Working set (KB): 1575168, committed (KB): 11815008, memory utilization: 13%.
2007-09-24 18:48:46.31 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 655 seconds. Working set (KB): 2162688, committed (KB): 11815008, memory utilization: 18%.
2007-09-24 18:53:08.66 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 918 seconds. Working set (KB): 2822472, committed (KB): 11815008, memory utilization: 23%.
2007-09-24 18:58:40.54 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1250 seconds. Working set (KB): 1395628, committed (KB): 11815072, memory utilization: 11%.
2007-09-24 19:03:02.89 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1512 seconds. Working set (KB): 1275492, committed (KB): 11815256, memory utilization: 10%.
2007-09-24 19:08:31.32 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1840 seconds. Working set (KB): 1282192, committed (KB): 11815256, memory utilization: 10%.
2007-09-24 19:38:05.65 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 3615 seconds. Working set (KB): 2362296, committed (KB): 11815328, memory utilization: 19%.
2007-09-24 20:38:13.00 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 7222 seconds. Working set (KB): 1108300, committed (KB): 11816096, memory utilization: 9%.
2007-09-24 22:38:36.63 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 14446 seconds. Working set (KB): 1303440, committed (KB): 11816408, memory utilization: 11%.
2007-09-25 00:48:56.94 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 0 seconds. Working set (KB): 280488, committed (KB): 11824024, memory utilization: 2%.
2007-09-25 00:54:24.84 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 327 seconds. Working set (KB): 3024340, committed (KB): 11816856, memory utilization: 25%.
2007-09-25 00:59:52.78 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 655 seconds. Working set (KB): 1371272, committed (KB): 11816792, memory utilization: 11%.
2007-09-25 01:04:17.63 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 920 seconds. Working set (KB): 1883076, committed (KB): 11819416, memory utilization: 15%.
2007-09-25 01:09:45.54 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1248 seconds. Working set (KB): 2768128, committed (KB): 11815920, memory utilization: 23%.
2007-09-25 01:14:07.89 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1510 seconds. Working set (KB): 3098484, committed (KB): 11818992, memory utilization: 26%.
2007-09-25 01:19:35.82 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1838 seconds. Working set (KB): 3467688, committed (KB): 11818992, memory utilization: 29%.
2007-09-25 01:49:06.62 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 3609 seconds. Working set (KB): 1569788, committed (KB): 11819248, memory utilization: 13%.
2007-09-25 02:49:13.59 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 7216 seconds. Working set (KB): 1026696, committed (KB): 11816560, memory utilization: 8%.
2007-09-25 04:49:27.58 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 14430 seconds. Working set (KB): 883140, committed (KB): 11816112, memory utilization: 7%.
2007-09-25 08:49:11.24 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 28814 seconds. Working set (KB): 2200932, committed (KB): 11821416, memory utilization: 18%.
2007-09-25 16:49:20.97 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 57623 seconds. Working set (KB): 2266832, committed (KB): 11821936, memory utilization: 19%.
2007-09-25 18:33:46.73 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 0 seconds. Working set (KB): 115004, committed (KB): 11822752, memory utilization: 0%.
2007-09-25 18:39:14.69 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 327 seconds. Working set (KB): 1678212, committed (KB): 11822368, memory utilization: 14%.
2007-09-25 18:44:42.61 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 655 seconds. Working set (KB): 2326272, committed (KB): 11822368, memory utilization: 19%.
2007-09-25 18:49:04.92 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 918 seconds. Working set (KB): 1042948, committed (KB): 11822304, memory utilization: 8%.
2007-09-25 18:54:36.82 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1250 seconds. Working set (KB): 669164, committed (KB): 11822304, memory utilization: 5%.
2007-09-25 18:58:59.15 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1512 seconds. Working set (KB): 672332, committed (KB): 11822304, memory utilization: 5%.
2007-09-25 19:04:34.64 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1847 seconds. Working set (KB): 1961080, committed (KB): 11822424, memory utilization: 16%.
2007-09-25 19:34:05.68 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 3618 seconds. Working set (KB): 1811564, committed (KB): 11822432, memory utilization: 15%.
2007-09-25 20:34:20.75 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 7233 seconds. Working set (KB): 2379140, committed (KB): 11823072, memory utilization: 20%.
2007-09-25 22:34:47.29 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 14460 seconds. Working set (KB): 586956, committed (KB): 11823320, memory utilization: 4%.
2007-09-26 01:49:17.29 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 0 seconds. Working set (KB): 26792, committed (KB): 11831984, memory utilization: 0%.
2007-09-26 01:54:45.25 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 327 seconds. Working set (KB): 3004440, committed (KB): 11824048, memory utilization: 25%.
2007-09-26 02:00:13.21 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 655 seconds. Working set (KB): 3205048, committed (KB): 11826736, memory utilization: 27%.
2007-09-26 02:04:35.56 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 918 seconds. Working set (KB): 3487836, committed (KB): 11824560, memory utilization: 29%.
2007-09-26 02:10:03.47 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1246 seconds. Working set (KB): 842648, committed (KB): 11827568, memory utilization: 7%.
2007-09-26 02:14:25.79 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1508 seconds. Working set (KB): 2090396, committed (KB): 11823600, memory utilization: 17%.
2007-09-26 02:19:53.70 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 1836 seconds. Working set (KB): 2348868, committed (KB): 11823600, memory utilization: 19%.
2007-09-26 02:49:24.37 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 3607 seconds. Working set (KB): 882912, committed (KB): 11824536, memory utilization: 7%.
2007-09-26 03:49:31.33 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 7213 seconds. Working set (KB): 774544, committed (KB): 11824536, memory utilization: 6%.
2007-09-26 05:49:46.99 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 14429 seconds. Working set (KB): 1189096, committed (KB): 11827104, memory utilization: 10%.
2007-09-26 09:49:18.56 spid1s A significant part of sql server process memory has been paged out. This may result in a performance degradation. Duration: 28800 seconds. Working set (KB): 1769260, committed (KB): 11828504, memory utilization: 14%.