Respiratory rate (RR) is a critical health indicator often monitored under inconvenient scenarios, limiting its practicality for continuous monitoring. Photoplethysmography (PPG) sensors, increasingly integrated into wearable devices, offer a chance to continuously estimate RR in a portable manner. In this paper, we propose RespDiff, an end-to-end multi-scale RNN diffusion model for respiratory waveform estimation from PPG signals. RespDiff does not require hand-crafted features or the exclusion of low-quality signal segments, making it suitable for real-world scenarios. The model employs multi-scale encoders, to extract features at different resolutions, and a bidirectional RNN to process PPG signals and extract respiratory waveform. Additionally, a spectral loss term is introduced to optimize the model further. Experiments conducted on the BIDMC dataset demonstrate that RespDiff outperforms notable previous works, achieving a mean absolute error (MAE) of 1.18 bpm for RR estimation while others range from 1.66 to 2.15 bpm, showing its potential for robust and accurate respiratory monitoring in real-world applications.
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