Real-Time Physiological Activity and Sleep State Monitoring System Using TS2Vec Embeddings and DBSCAN Clustering for Heart Rate and Motor Response Analysis in IoMT

Monitoring physiological activity and sleep states in real time is challenging, particularly for continuous assessment in daily life settings using wearable IoMT devices. We developed a 24 h wearable system that integrates electrocardiogram (ECG) electrodes for heart rate measurement and a glove-mounted flex sensor for motor responses, connected through an Internet of Medical Things (IoMT) platform. Flex signals were combined using principal component analysis (PCA) to generate a single kinematic channel, then standardized with heart rate. Time-series windows were embedded using TS2Vec and clustered with DBSCAN, while t-SNE was applied only for visualization. The framework identified four physiologically coherent states: (i) nocturnal sleep with the lowest heart rate and minimal motion, (ii) evening pre-sleep with low movement and moderately higher heart rate, (iii) daytime activity with variable motion and mid-range heart rate, and (iv) late-day high-intensity activity with the highest heart rate and increased motor responses. A few outliers were observed during transient body movements or sensor readjustments, which were identified and excluded during preprocessing to ensure stable clustering results. Across 24 h, heart rate ranged from 52 to 96 bpm (mean 77.4), while flexion spanned 0 to 165° (mean 52.5°), showing alignment between movement intensity and cardiac response. This integrated sensing and analytics pipeline provides an interpretable, subject-specific state map that enables continuous remote monitoring of physiological activity and sleep patterns.