Apple Watch notifications not working

I've noticed over the past month or so I am not receiving the all the alerts set up on my watch. Most noticeably when I get a text, there is no vibration, preview or dot indicating that a new message was received. However on my phone Lock Screen is the notification even though there was no vibration from the phone indicating a new message (I assume because the phone thinks I was alerted on the phone so it does not alert me per the set up). I have very few other apps set up with notifications on my watch but am having the same experience with Instagram. Notifications that are native to the watch itself, like Activity, still work fine.

The only solution that has worked so far is to unpair and re-pair my watch, then notifications work correctly for about a week. Phone and Watch are both always up to date on OS. Phone is a 12 Pro and Watch is a Series 4.