Comparative Analysis of State-of-the-Art Foundation Models for Sleep Analysis Under Channel Reduction

Abstract

Automatic sleep staging from polysomnography (PSG) is a well-studied task, but PSG itself is expensive, clinic-based, and burdensome to manually score, which limits its use for long-term or at-home monitoring. Most existing sleep-staging foundation models are evaluated using the full PSG montage. We instead ask how much of that montage is actually necessary. We evaluate six sleep staging models on the Multi-Ethnic Study of Atherosclerosis (MESA) PSG dataset across three signal conditions: electroencephalography (EEG), electrocardiography (ECG), and their combination (EEG+ECG). This is motivated by edge-cloud deployment, where EEG requires a clinic-grade scalp electrode, whereas ECG is already captured by consumer wearables. We test state-of-the-art foundation models such as SleepFM with an encoder trained from scratch on MESA, alongside BIOT, MOMENT, LaBraM, a base-scale Vision Transformer (ViT-B) reimplementation of SensorLM trained from scratch, and YASA, spanning EEG-pretrained, general-time-series, from-scratch, and classical non-learned approaches. No model architecture is modified from its original form; SensorLM's encoder is reimplemented only in PyTorch. For EEG-only staging, BIOT achieves the best result with a macro~F1 of 0.7237, followed by LaBraM (0.6835) and SleepFM from scratch (0.6582). Across the five models capable of ECG-only staging, switching from EEG to ECG costs between 0.2798 (MOMENT) and 0.4151 (BIOT) macro~F1, averaging 0.3531, while cutting the raw channel data rate to a third. Adding ECG to EEG provides no gain for most models. These results show that EEG carries most of the sleep-staging signal, quantify the consistent accuracy cost of the wearable-compatible alternative, and demonstrate that sleep-relevant pretraining transfers well to MESA.