Premiere Pro problems with too many items in assembly

I'm having a persistent issue with Adobe and my YouTube videos where sometimes I have to have upwards of 50+ items of varying types in the assembly including PNG files, MP4 clips, and WAV files.

It tends to vary, but usually once I breach the 50 item mark Premiere seems to hang and the only way to get the display to update is to open and close the File Menu from the taskbar. The system remains fully functional but it becomes editing by brail and having to click on "File" to see what changes were made. Does anyone know why that is and what I might be able to do to avoid this issue? At first I thought it might be performance but I'm never maxed out on any system resources.

System SPecs:

I7-8700K (3.7GHz)

32GB RAM

NVidia GTX 1080 Ti

Adobe installation and all files/caching on a Samsung 960 Pro M.2

Premiere Pro version 13.1.1 Build 11