講師資料
Talks：
Sleep technology in COMISA care: evidence based assessment methods and therapeutic enhancements
睡眠科技在COMISA 的評估與改善策略
Name：
劉文德（Wen-Te Liu）
Position：
1. Professor, School of Respiratory Therapy, College of Medicine, Taipei Medical University
2. Attending Physician, Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University
Affiliation：
1. School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei 11052, Taiwan.
2. Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.
Email：
Photo：
Research Interests：
Sleep medicine, Obstructive sleep apnea, Artificial intelligence in medicine, pulmonary medicine
Selected Publications：
1. Chiu CC, Liu WT, Kang JH, Chen CC, Ho YH, Huang YW, Tsai ZL, Chien R, Chen YY, Chen YL, Chang NW, Lu HW, Lee KY, Majumdar A, Liao SH, Liu JC, Tsai CY. Evaluating Cardiac Impairment From Abnormal Respiratory Patterns: Insights From a Wireless Radar and Deep Learning Study. IEEE J Transl Eng Health Med. 2025 Jul 14;13:323-332. doi: 10.1109/JTEHM.2025.3588523. PMID: 40740837; PMCID: PMC12310173.
2. Kuo CF, Lin YC, Chen ZY, Kang JH, Chang CC, Chen Z, Majumdar A, Chen YL, Kuan YC, Lee KY, Feng PH, Chen KY, Lee HC, Cheng WH, Liu WT (co-correspondence), Tsai CY. From reactive to proactive: Machine learning models for continuous positive airway pressure adjustments using heart rate variability and oximetry-related parameters. Digit Health. 2025 Apr 28;11:20552076251339273. doi: 10.1177/20552076251339273. PMID: 40343061; PMCID: PMC12059434.
3. Tsai CY, Su CL, Huang HT, Lin HW, Lin JW, Hei NC, Cheng WH, Chen YL, Majumdar A, Kang JH, Lee KY, Chen Z, Lin YC, Wu CJ, Kuan YC, Lin YT, Hsu CR, Lee HC, Liu WT (co-correspondence). Mediating role of obstructive sleep apnea in altering slow-wave activity and elevating Alzheimer's disease risk: Pilot study from a northern Taiwan cohort. Sleep Health. 2024 Oct 16:S2352-7218(24)00188-8. doi: 10.1016/j.sleh.2024.08.012. Epub ahead of print. PMID: 39419711.
4. Lin SY, Tsai CY, Majumdar A, Ho YH, Huang YW, Kao CK, Yeh SM, Hsu WH, Kuan YC, Lee KY, Feng PH, Tseng CH, Chen KY, Kang JH, Lee HC, Wu CJ, Liu WT (correspondence). Combining wireless radar sleep monitoring device with deep machine learning techniques to assess obstructive sleep apnea severity. J Clin Sleep Med. 2024 Mar 28. doi: 10.5664/jcsm.11136. Epub ahead of print. PMID: 38546033.
5. Kuo CF, Tsai CY, Cheng WH, Hs WH, Majumdar A, Stettler M, Lee KY, Kuan YC, Feng PH, Tseng CH, Chen KY, Kang JH, Lee HC, Wu CJ, Liu WT (correspondence). Machine learning approaches for predicting sleep arousal response based on heart rate variability, oxygen saturation, and body profiles. Digit Health. 2023 Oct 13;9:20552076231205744. doi: 10.1177/20552076231205744. PMID: 37846406; PMCID: PMC10576931.
Abstract：
Comorbid insomnia and sleep apnea (COMISA) represents one of the most challenging clinical subtypes of sleep apnea. Because patients suffer from both chronic insomnia and obstructive sleep apnea (OSA), their sleep quality is profoundly impaired. These individuals typically present with sympathetic overactivation and difficulty maintaining sleep. From a respiratory control perspective, they often demonstrate increased respiratory drive and heightened ventilation, which further aggravates upper airway collapsibility. Over time, repetitive obstructions and arousals produce vibration trauma and neurogenic inflammation of the upper airway mucosa, perpetuating a vicious cycle of sleep fragmentation and airway dysfunction.
Assessment in this group is also problematic. Standard in-lab polysomnography (PSG) may not fully capture real-world sleep patterns due to patients’ hyperarousal. As a result, alternative, less intrusive tools such as millimeter-wave radar and fiber-optic mattress sensors may provide more ecologically valid measures of heart rate variability (HRV) and respiratory sinus arrhythmia (RSA) coupling, thereby yielding deeper insight into true sleep quality.
Traditional interventions—CPAP or oral appliances—often show poor tolerance in COMISA patients, as the insomnia component undermines adherence. This context highlights the potential of novel approaches such as frequency-specific microcurrent (FSM) stimulation. By applying targeted microcurrents at specific frequencies, FSM can attenuate sympathetic activity, improve sleep continuity, and stabilize upper airway function. A recent randomized double-blind trial demonstrated that FSM not only enhanced objective sleep quality (improved efficiency, reduced WASO, increased N3 sleep) but also reduced indices of airway instability. Together, these findings suggest that FSM offers a promising new therapeutic direction for COMISA patients, addressing both hyperarousal and respiratory vulnerability simultaneously.
2025年會：