# Clinical Evaluation of Sleep Foundation Models

This Commentary reviews recently published sleep foundation models by comparing their training cohorts, assessment frameworks, and reported performance, and applies an existing sleep foundation model without fine-tuning to an independent cohort of patients with Narcolepsy Type 1 (n = 51) and healthy controls (n = 28), finding modest zero-shot sleep-staging performance below supervised methods on the same cohort and minimal improvement in disorder classification from PSG-derived embeddings beyond demographic baselines, concluding that sleep foundation models are not yet suitable for clinical deployment.

This Commentary reviews recently published sleep foundation models by comparing their training cohorts, assessment frameworks, and reported performance, and applies an existing sleep foundation model without fine-tuning to an independent cohort of patients with Narcolepsy Type 1 (n = 51) and healthy controls (n = 28), finding modest zero-shot sleep-staging performance below supervised methods on the same cohort and minimal improvement in disorder classification from PSG-derived embeddings beyond demographic baselines, concluding that sleep foundation models are not yet suitable for clinical deployment.