This post led me to ask that question.

Cache contention

On a large site, if you are using MyISAM, contention occurs in the database tables when the cache is forced to clear after a node or a comment is added. With tens of thousands of filter text snippets needing to be deleted, the table will be locked for a long period, and any accesses to it will be queued pending the purge of the data in it. The same is true for the page cache as well.

This often causes a "site hang" for a minute or two. During that time new requests keep piling up, and if you do not have the MaxClients parameter in Apache setup correctly, the system can go into thrashing because of excessive swapping.