Zequan Liang, Elahe Hosseini, Ning Miao et al.
Continuous oxygen saturation (SpO$_2$) estimation from wearable photoplethysmography (PPG) is important for long-term health monitoring, but low-quality red and infrared PPG segments can distort waveform morphology and degrade SpO$_2$ prediction accuracy. Existing PPG denoising and reconstruction methods usually optimize waveform fidelity or heart rate characteristics, while time-domain waveform loss on PPG signals alone insufficiently preserves frequency structure and SpO$_2$-relevant information. This paper proposes a SpO$_2$ predictor-guided stage-wise time-frequency reconstruction framework for low-quality dual-wavelength PPG signals. The proposed method first selects high-quality PPG segments to pretrain a SpO$_2$ predictor. A masked reconstruction model is then trained to recover randomly masked PPG regions using a joint reconstruction objective that combines time-domain waveform loss with frequency-domain loss computed from the short-time Fourier transform (STFT). To make the reconstruction task physiologically relevant, the pretrained SpO$_2$ predictor is incorporated as an additional constraint, encouraging the reconstructed PPG to preserve SpO$_2$ information rather than only minimizing waveform reconstruction error. The SpO$_2$ predictor and PPG reconstructor model are optimized through four training stages. Experiments on the public OpenOximetry Repository and a private wearable PPG dataset show that the proposed approach achieves the lowest subject-level MAE, with 2.882\% on the public dataset and 2.359\% on the private dataset.