Unsupervised domain transfer: Overcoming signal degradation in sleep monitoring by increasing scoring realism

Sleep foundation models have recently demonstrated strong performance on in-domain polysomnography tasks, including sleep staging, apnea detection, and disease risk prediction. In this work, we investigate whether sleep biosignals can serve as an effective pretraining distribution for learning representations that transfer beyond sleep to adjacent domains. Following sleep foundation models, we perform sleep-only multimodal contrastive pretraining (with a leave-one-out objective) and evaluate transfer to non-sleep EEG and ECG, two well-benchmarked biosignal modalities with heterogeneous datasets and clinically meaningful downstream tasks. Across eight downstream tasks spanning multiple EEG and ECG datasets, sleep pretraining consistently improves performance relative to training from scratch. Moreover, on several tasks, we achieve performance competitive with or surpassing prior specialized state-of-the-art and foundation models.

Existing deep learning approaches for automatic sleep staging suffer from limited robustness under heterogeneous recording conditions, where non-stationary noise, inter-subject differences and cross-dataset distribution shifts cause unstable features and poor generalization. This work proposes DualStabSleepNet (DSSNet), a dual-domain diffusion stabilization network for robust sleep staging, which improves robustness in both data and feature domains. After preprocessing multi-channel polysomnography (PSG), a continuous-scale diffusion-based stabilization module suppresses noise while preserving physiological signal structures. Stabilized signals are converted to time-frequency representations and fed into a Vision Transformer backbone. A teacher-student guided diffusion feature stabilization module further mitigates feature drift and enforces multi-level feature consistency. Evaluated on four public PSG datasets SleepEDF-20, SleepEDF-78, SHHS and ISRUC-S3, DSSNet achieves state-of-the-art accuracy of 89.2%, 88.0%, 89.7%, 86.7% with improved macro-F1 and Cohen's kappa. It obtains notable improvements on hard transitional stages (e.g., 12.5% gain for N1 on SHHS) and boosts N2/REM recognition. Under cross-dataset settings, DSSNet is robust to distribution shift and performs on par with or superior to target-dataset trained baselines, demonstrating its practical potential for real-world sleep staging across heterogeneous cohorts.

Automatic sleep staging is a multimodal learning problem involving heterogeneous physiological signals such as EEG and EOG, which often suffer from domain shifts across institutions, devices, and populations. In practice, these data are also affected by noisy annotations, yet label-noise-robust multi-source domain generalization remains underexplored. We present the first benchmark for Noisy Labels in Multi-Source Domain-Generalized Sleep Staging (NL-DGSS) and show that existing noisy-label learning methods degrade substantially when domain shifts and label noise coexist. To address this challenge, we propose FF-TRUST, a domain-invariant multimodal sleep staging framework with Joint Time-Frequency Early Learning Regularization (JTF-ELR). By jointly exploiting temporal and spectral consistency together with confidence-diversity regularization, FF-TRUST improves robustness under noisy supervision. Experiments on five public datasets demonstrate consistent state-of-the-art performance under diverse symmetric and asymmetric noise settings. The benchmark and code will be made publicly available at https://github.com/KNWang970918/FF-TRUST.git.