Interest in the Wireless Medical Sensor Network (WMSN) is rapidly gaining attention thanks to recent advances in semiconductors and wireless communication. However, by virtue of the sensitive medical applications and the stringent resource constraints, there is a need to develop a routing protocol to fulfill WMSN requirements in terms of delivery reliability, attack resiliency, computational overhead and energy efficiency. This doctoral research therefore aims to advance the state of the art in routing by proposing a lightweight, reliable routing protocol for WMSN. Ensuring a reliable path between the source and the destination requires making trustaware routing decisions to avoid untrustworthy paths. A lightweight and effective Trust Management System (TMS) has been developed to evaluate the trust relationship between the sensor nodes with a view to differentiating between trustworthy nodes and untrustworthy ones. Moreover, a resource-conservative Reinforcement Learning (RL) model has been proposed to reduce the computational overhead, along with two updating methods to speed up the algorithm convergence. The reward function is re-defined as a punishment, combining the proposed trust management system to defend against well-known dropping attacks. Furthermore, with a view to addressing the inborn overestimation problem in Q-learning-based routing protocols, we adopted double Q-learning to overcome the positive bias of using a single estimator. An energy model is integrated with the reward function to enhance the network lifetime and balance energy consumption across the network. The proposed energy model uses only local information to avoid the resource burdens and the security concerns of exchanging energy information. Finally, a realistic trust management testbed has been developed to overcome the limitations of using numerical analysis to evaluate proposed trust management schemes, particularly in the context of WMSN. The proposed testbed has been developed as an additional module to the NS-3 simulator to fulfill usability, generalisability, flexibility, scalability and high-performance requirements
