A Neuro-Symbolic System for Interpretable Multimodal Physiological Signals Integration in Human Fatigue Detection

Foundation models offer a promising route to compress multi-modal physiological signals into compact representations of human health, with broad applications across sleep medicine, cardiology, neurology and other healthcare domains. Existing models have typically been trained with masked-reconstruction or contrastive objectives. However, masked reconstruction may be poorly suited to the stochastic nature of these signals, while contrastive approaches rely on positive-pair definitions despite the semantic invariances of physiological signals being poorly understood. In this work, we show that next-token prediction is a simple and scalable alternative. We develop Hypnos, a multi-modal sleep foundation model trained using eight different sensing modalities (e.g. EEG, ECG, respiratory signals) drawn from over 20,000 overnight polysomnography recordings. We tokenize each modality into streams of discrete tokens using residual vector quantization, then train a large auto-regressive RQ-Transformer to jointly predict the next token across all modalities in parallel. After training, Hypnos can be applied to continuous streams of sensor data from any subset of supported modalities, generating embeddings for downstream tasks. Across a range of benchmarks, Hypnos significantly outperforms existing foundation models. In sleep stage classification, we match the performance of strong supervised baselines on held-out test sets whilst using $100\times$ less labelled data. Hypnos even generalises to daytime physiology, surpassing a dedicated ECG foundation model at detecting atrial fibrillation. Our results demonstrate that next-token prediction is a strong self-supervised objective for representation learning from multi-modal physiological signals.

Human cognitive performance is constrained by limited mental resources, yet continuous computational estimation of cognitive capacity dynamics remains an open challenge. We propose a theory-driven multimodal learning framework that models capacity-related cognitive state as a two-dimensional physiological representation defined by voluntary resource allocation (mental effort) and overload-related strain (stress). The proposed architecture combines dual-stream encoding of cardiac (IBI/HRV) and electrodermal (EDA) signals with late fusion and task-specific output heads that independently estimate probabilistic effort and stress states. Evaluation on the SWELL-KW dataset using strict leave-one-subject-out cross-validation demonstrates cross-individual generalization (stress: 70.0% balanced accuracy; effort: 72.2%), with significant gains from multimodal integration and theory-guided supervision. Rather than collapsing physiological dynamics into a single workload label, the proposed effort--stress state-space enables structured differentiation between distinct cognitive regimes, including productive engagement and overload-related strain. Predicted state trajectories exhibit significant demand-sensitive shifts under controlled workload manipulations, with effort and stress responding differentially across interruption and time-pressure conditions. These results suggest that physiologically grounded multidimensional state representations may provide a foundation for adaptive systems capable of continuous capacity-aware monitoring and human-centered interaction.

Analyzing physiological sleep signals is important for assessing sleep quality and detecting sleep-related disorders. Learning inter-modal relationships across physiological signals can provide richer representations for downstream sleep analysis. We introduce SleepPairNet, a multimodal self-supervised learning (SSL) framework that learns pairwise interactions between physiological signals through cross-attention. We propose a random modality-pair selection strategy that exposes the model to diverse signal pairs during pretraining, enabling flexibility across modality combinations at test time. Pretrained on the NCH dataset, SleepPairNet outperforms the evaluated SSL baselines on all respiratory tasks while remaining competitive on EEG-related tasks, and shows even stronger results when transferred to the external CHAT dataset.