Deep Learning for Sleep Heart Rate Estimation from Accelerometers: Toward Population-Scale Cardiac Insight Without Optical Sensors

Abstract

Large longitudinal cohorts often contain wrist accelerometry without optical heart-rate sensing, motivating recovery of cardiac information from motion signals already collected during sleep. We present SeqSmoother, a transformer-based temporal corrector for sleep heart rate (HR) estimation from wrist accelerometry. SeqSmoother combines spectral descriptors with an intermediate Nightbeat-derived frequency anchor and a physics-motivated sub-harmonic feature designed to identify harmonic frequency lock-on. All inference-time features are derived from wrist accelerometry, while ECG is used only to construct reference HR labels and training-label quality weights. We evaluate SeqSmoother using 13 participant-disjoint held-out folds and compare it with the official Nightbeat implementation under a matched 60-s window and 15-s step protocol. Across all out-of-fold predictions, SeqSmoother achieved a participant-macro MAE of 1.60 bpm. On Nightbeat-retained matched intervals, Nightbeat achieved lower absolute error than SeqSmoother (0.615 versus 1.091 bpm), while SeqSmoother provided estimates over a larger portion of the eligible recording; Nightbeat produced final estimates for 72.85% of the SeqSmoother-eligible out-of-fold grid. Separately, the proposed sub-harmonic ratio achieved an AUROC of 0.972 for identifying reference-defined harmonic lock-on candidates. These findings reveal an accuracy-availability trade-off between learned temporal modeling and quality-gated signal processing while providing empirical support for a physics-informed approach to identifying frequency-tracking failures in accelerometer-based sleep HR estimation.