We introduce methods for the analysis of large populations of sleep architectures (hypnograms) that respect the 5-state 20-transition-type structure defined by the American Academy of Sleep Medicine. By applying these methods to the hypnograms of 5598 subjects from the Sleep Heart Health Study we: 1) provide the firrst analysis of sleep hypnogram data of such size and complexity in a community cohort with a 4-level comorbidity; 2) compare 5-state 20-transition-type sleep to 3-state 6-transition-type sleep for a check of feasibility and information-loss; 3) extend current approaches to multivariate survival data analysis to populations of time-to-transition processes; and 4) provide scalable solutions for data analyses required by the case study. This allows us to provide detailed new insights into the association between sleep apnea and sleep architecture. Supporting R as well as SAS code and data are included in the online supplementary materials.



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