WavesFM: Hierarchical Representation Learning for Longitudinal Wearable Sensor Waveforms

Wearable sensors enable the continuous acquisition of high-resolution physiological waveforms, such as photoplethysmography and accelerometry, under free-living conditions. However, inferring health-related phenotypes from these signals presents significant challenges due to high sampling frequencies, multimodal dependencies, and extreme sequence lengths (e.g., weeks of recordings), compounded by a scarcity of ground-truth labels. To address these challenges, existing self-supervised learning (SSL) methodologies typically follow two paradigms: (1) learning rich morphological representations from short waveform segments while collapsing longitudinal dynamics through simple aggregation, or (2) modeling behavioral patterns from coarse, hand-crafted features (e.g. heart rate, step counts) spanning longer horizons but foregoing subtle, predictive signatures in raw waveforms. To bridge this gap, we propose WavesFM, a foundation model utilizing a two-stage SSL framework for longitudinal physiological data. Specifically, we decompose the learning problem into two stages: first, a segment-level encoder is pretrained to extract local embeddings from short waveforms; subsequently, a temporal encoder is trained to model the sequence of these embeddings across a multi-day horizon. This hierarchical approach overcomes the computational complexity of high-resolution, long-sequence data, allowing the overall model to capture both local signal semantics and the complex circadian and inter-day variations governing physiological dynamics. Pretrained on over 6.8M hours (N=324k individuals) of recordings for the first stage and 5.3M hours (N=10k) for the second stage, WavesFM demonstrates superior performance across 58 diverse tasks spanning demographics, lifestyle, health conditions, and medications.