It's a Windows app - if you are worried about overhead, you wouldn't be running Windows in the first place.
But to answer your question, I am sure this has plenty of overhead, but given there are no real alternatives, people still accept it. Better to waste some CPU time that have some totally unresponsive game.
- Why BES vs lowering process priority.
- Why BES vs lowering CPU clock.
- What algorithm does BES use for when to suspend/unsuspend? (sigma-delta? PWM perhaps? what is the period?)