A foundation model of wearable pulse oximetry reveals physiological signatures of health and cardiometabolic risk (PulseOx-FM)
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PulseOx-FM is a self-supervised model trained on 6,995,558 pulse oximetry segments from 42,282 overnight recordings of 10,704 people in the Human Phenotype Project. It predicted age better than existing feature methods and held up in an external cohort. Its representations predicted 64 cardiometabolic and neuropsychiatric phenotypes and flagged two-year hypertension risk in people with normal blood pressure.
- Signals: PPG, SpO2
- Venue
- openRxiv
- Published
- 2026
- arXiv
- Not reported
- PMID
- Not reported
- Form factor
- Not reported
- Models
- Subjects
- 10,704 participants
- Code
- Not reported
- Added
- Oct 11, 2026
Abstract
While Photoplethysmography (PPG) is established as a noninvasive optical tool for monitoring heart rate and oxygen saturation, its high-resolution blood flow waveforms contain rich physiological data that extend far beyond conventional vital signs.
We introduce PulseOx-FM, a foundation model, trained using self-supervised learning on 6,995,558 segments of pulse oximetry signals collected during 42,282 overnight sleep monitoring recordings of 10,704 participants in the Human Phenotype Project (HPP).
Using chronological age as a global health benchmark, PulseOx-FM significantly outperformed existing open-source and proprietary feature extraction methods while demonstrating robust generalization in an external out-of-distribution cohort. PulseOx-FM representations predicted 64 phenotypic targets spanning cardiometabolic, and neuropsychiatric domains beyond demographic baselines, and prospectively identified two-year hypertension incidence in normotensive individuals. Nightly embeddings further tracked next-day glycemic, dietary and activity-based state within individuals, dissociating this signal from sleep architecture alone. This next-day glycemic signal was predominantly a direct physiological effect, not explained by next-day dietary intake.
These findings suggest that PulseOx-FM provides a generalizable framework for encoding physiological patterns from sleep, offering a non-invasive tool for global health risk stratification and precision medicine.
Verbatim fromthe publisher's DOI record· Publisher licence: http://creativecommons.org/licenses/by/4.0/
How it works
- Cohort
- 10,704 participants
Models introduced or evaluated· 1
Cite
@article{pulseoxfmwearablepulseox2026,
title = {{A foundation model of wearable pulse oximetry reveals physiological signatures of health and cardiometabolic risk (PulseOx-FM)}},
author = {Sarah Kohn and Guy Lutsker and Alon Diament and Smadar Shilo and Adam Gabet and Gil Sasson and Gili Wolf and Adva Wolf and Anastasia Godneva and Adina Weinberger and Hagai Rossman and Eran Segal},
year = {2026},
journal = {openRxiv},
doi = {10.64898/2026.07.01.26356992}
}History
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