# Women's Health Initiative Sleep Hypoxia Effects on Resilience (WHISPER)

> **NIH NIH R01** · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2020 · $1,159,882

## Abstract

SUMMARY
Sleep disorders and disturbances in older adults are common, yet frequently undiagnosed and untreated. The prevalence of most
sleep problems increases with advancing age and may be attributable to underlying medical or psychiatric conditions, medication use,
or sleep abnormalities such as upper airway obstruction referred to as sleep-disordered breathing (SDB). Compelling epidemiological
data implicate SDB, particularly intermittent hypoxia (IH), in increasing rates of cardiovascular disease (CVD), cancers and cognitive
impairment, including Alzheimer's disease (AD) and related dementias. Although other studies have examined the association of SDB
on CVD risk in men and younger women, most are cross-sectional in nature or largely exclude elderly women who are characteristically
at high risk of significant vascular disease. No large clinical study has prospectively examined the role of SDB on cancer incidence and
aggressiveness, despite strong evidence from animal studies indicating that hypoxemia promotes tumor growth via multiple
mechanisms, and on cognitive trajectory and incident mild cognitive impairment (MCI) and AD in older adults. To date, no prior
sufficiently powered study has examined the predictive value of SDB for these poor health outcomes in elderly women. We propose to
capitalize on the unique and rich, but time-limited resources of the Women's Health Initiative (WHI) that provide a solid infrastructure
and an extensive data repository to address key questions regarding the role of SDB and other measures of disturbed sleep on poor
health and cognitive outcomes in a large, well-characterized cohort of elderly women. We will leverage resources provided by the WHI
Southeast Regional Center at Wake Forest for the conduct of the study and expertise in CVD, cancer, cognitive assessment and
MCI/AD; and by Brigham and Women's Hospital/Harvard and California Pacific Medical Center for expertise in sleep, CVD, and cancer.
We will use a validated, low burden strategy for data collection that ensures diverse geographical representation at a fraction of the
cost associated with clinic-based assessments, including: 1) wrist-worn devices to provide continuous sleep measurements of oxygen
desaturation, heart rate, and activity at baseline; 2) mail and telephone assessments; and 3) data sharing with WHI and its ancillary
studies. Sleep studies will be conducted using pulse oximetry and actigraphy in 5000 women who are already being followed for CVD
and cancer outcomes through other WHI efforts. Adjudicated cancer and CVD outcomes will be collected for 3 years of follow-up, and
cognitive function will be assessed via telephone for 3 years of follow-up using well-established validated protocols developed for the
WHI Memory Studies. These data may provide the scientific impetus to support the use of new emerging ubiquitously accessible and
affordable devices that could provide cost-effective assessments of hypoxemia as part of routine clinical...

## Key facts

- **NIH application ID:** 9983816
- **Project number:** 5R01HL133684-04
- **Recipient organization:** WAKE FOREST UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Laura D. Baker
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $1,159,882
- **Award type:** 5
- **Project period:** 2017-09-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9983816

## Citation

> US National Institutes of Health, RePORTER application 9983816, Women's Health Initiative Sleep Hypoxia Effects on Resilience (WHISPER) (5R01HL133684-04). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/9983816. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*