Abstract:Continuous monitoring and accurate detection of complex sleep patterns associated to different sleep-related conditions is essential, not only for enhancing sleep quality but also for preventing the risk of developing chronic illnesses associated to unhealthy sleep. Despite significant advances in research, achieving versatile recognition of various unhealthy and sub-healthy sleep patterns with simple wearable devices at home remains a significant challenge. Here, we report a robust and durable ultrasensitive strain sensor array printed on a smart garment, in its collar region. This solution allows detecting subtle vibrations associated with multiple sleep patterns at the extrinsic laryngeal muscles. Equipped with a deep learning neural network, it can precisely identify six sleep states-nasal breathing, mouth breathing, snoring, bruxism, central sleep apnea (CSA), and obstructive sleep apnea (OSA)-with an impressive accuracy of 98.6%, all without requiring specific positioning. We further demonstrate its explainability and generalization capabilities in practical applications. Explainable artificial intelligence (XAI) visualizations reflect comprehensive signal pattern analysis with low bias. Transfer learning tests show that the system can achieve high accuracy (overall accuracy of 95%) on new users with very few-shot learning (less than 15 samples per class). The scalable manufacturing process, robustness, high accuracy, and excellent generalization of the smart garment make it a promising tool for next-generation continuous sleep monitoring.