http://bugs.winehq.org/show_bug.cgi?id=50155
--- Comment #2 from johnstonljordan@gmail.com --- This bug should be closed, it was fixed by a patch that Proton was carrying that was merged into upstream wine. I don't know the commit number, but the patch was called "dwmapi: Sleep in DwmFlush()".
With that patch merged the high cpu usage (even on idle) with wineserver went away. There still are other performace realted issues that Fsync or WineSync help address, but this particular bug directly has to do with the dwmapi patch that was merged already.