diff --git a/changelog.d/17548.misc b/changelog.d/17548.misc
new file mode 100644
index 000000000..861b241dc
--- /dev/null
+++ b/changelog.d/17548.misc
@@ -0,0 +1 @@
+Fix performance of device lists in `/key/changes` and sliding sync.
diff --git a/synapse/handlers/device.py b/synapse/handlers/device.py
index ce26c91a7..4f2a9f3a5 100644
--- a/synapse/handlers/device.py
+++ b/synapse/handlers/device.py
@@ -267,31 +267,27 @@ class DeviceWorkerHandler:
                 newly_left_rooms.add(change.room_id)
 
         # We now work out if any other users have since joined or left the rooms
-        # the user is currently in. First we filter out rooms that we know
-        # haven't changed recently.
-        rooms_changed = self.store.get_rooms_that_changed(
-            joined_room_ids, from_token.room_key
-        )
+        # the user is currently in.
 
         # List of membership changes per room
         room_to_deltas: Dict[str, List[StateDelta]] = {}
         # The set of event IDs of membership events (so we can fetch their
         # associated membership).
         memberships_to_fetch: Set[str] = set()
-        for room_id in rooms_changed:
-            # TODO: Only pull out membership events?
-            state_changes = await self.store.get_current_state_deltas_for_room(
-                room_id, from_token=from_token.room_key, to_token=now_token.room_key
-            )
-            for delta in state_changes:
-                if delta.event_type != EventTypes.Member:
-                    continue
 
-                room_to_deltas.setdefault(room_id, []).append(delta)
-                if delta.event_id:
-                    memberships_to_fetch.add(delta.event_id)
-                if delta.prev_event_id:
-                    memberships_to_fetch.add(delta.prev_event_id)
+        # TODO: Only pull out membership events?
+        state_changes = await self.store.get_current_state_deltas_for_rooms(
+            joined_room_ids, from_token=from_token.room_key, to_token=now_token.room_key
+        )
+        for delta in state_changes:
+            if delta.event_type != EventTypes.Member:
+                continue
+
+            room_to_deltas.setdefault(delta.room_id, []).append(delta)
+            if delta.event_id:
+                memberships_to_fetch.add(delta.event_id)
+            if delta.prev_event_id:
+                memberships_to_fetch.add(delta.prev_event_id)
 
         # Fetch all the memberships for the membership events
         event_id_to_memberships = await self.store.get_membership_from_event_ids(
diff --git a/synapse/storage/databases/main/state_deltas.py b/synapse/storage/databases/main/state_deltas.py
index 7d491d172..eaa13da36 100644
--- a/synapse/storage/databases/main/state_deltas.py
+++ b/synapse/storage/databases/main/state_deltas.py
@@ -26,10 +26,11 @@ import attr
 
 from synapse.logging.opentracing import trace
 from synapse.storage._base import SQLBaseStore
-from synapse.storage.database import LoggingTransaction
+from synapse.storage.database import LoggingTransaction, make_in_list_sql_clause
 from synapse.storage.databases.main.stream import _filter_results_by_stream
-from synapse.types import RoomStreamToken
+from synapse.types import RoomStreamToken, StrCollection
 from synapse.util.caches.stream_change_cache import StreamChangeCache
+from synapse.util.iterutils import batch_iter
 
 logger = logging.getLogger(__name__)
 
@@ -200,3 +201,62 @@ class StateDeltasStore(SQLBaseStore):
         return await self.db_pool.runInteraction(
             "get_current_state_deltas_for_room", get_current_state_deltas_for_room_txn
         )
+
+    @trace
+    async def get_current_state_deltas_for_rooms(
+        self,
+        room_ids: StrCollection,
+        from_token: RoomStreamToken,
+        to_token: RoomStreamToken,
+    ) -> List[StateDelta]:
+        """Get the state deltas between two tokens for the set of rooms."""
+
+        room_ids = self._curr_state_delta_stream_cache.get_entities_changed(
+            room_ids, from_token.stream
+        )
+        if not room_ids:
+            return []
+
+        def get_current_state_deltas_for_rooms_txn(
+            txn: LoggingTransaction,
+            room_ids: StrCollection,
+        ) -> List[StateDelta]:
+            clause, args = make_in_list_sql_clause(
+                self.database_engine, "room_id", room_ids
+            )
+
+            sql = f"""
+                SELECT instance_name, stream_id, room_id, type, state_key, event_id, prev_event_id
+                FROM current_state_delta_stream
+                WHERE {clause} AND ? < stream_id AND stream_id <= ?
+                ORDER BY stream_id ASC
+            """
+            args.append(from_token.stream)
+            args.append(to_token.get_max_stream_pos())
+
+            txn.execute(sql, args)
+
+            return [
+                StateDelta(
+                    stream_id=row[1],
+                    room_id=row[2],
+                    event_type=row[3],
+                    state_key=row[4],
+                    event_id=row[5],
+                    prev_event_id=row[6],
+                )
+                for row in txn
+                if _filter_results_by_stream(from_token, to_token, row[0], row[1])
+            ]
+
+        results = []
+        for batch in batch_iter(room_ids, 1000):
+            deltas = await self.db_pool.runInteraction(
+                "get_current_state_deltas_for_rooms",
+                get_current_state_deltas_for_rooms_txn,
+                batch,
+            )
+
+            results.extend(deltas)
+
+        return results