Chuen-Ru Liu

Mrs. Chuen-Ru Liu

orcid

Research Focus & Metrics

Academic Career Length

4Years (2023-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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24 September 2024 in Clocks & Sleep
Verified
Journal Article
Open access
PDF file
CLChuen-Ru Liu
Chuen-Ru Liu
CYChih-Yuan Yang
Chih-Yuan Yang
DSDipanshu Sharma
Dipanshu Sharma
TCTun-Hao Chen
Tun-Hao Chen
XHXian-Qing Huang
Xian-Qing Huang
Jwo-Huei JouJwo-Huei Jou
Jwo-Huei Jou
In this study, we aimed to investigate the relationships between sleep duration and autonomic nervous system (ANS) regulation. This cross-sectional pilot study included 27 older patients with probable Alzheimer’s disease who were hospitalized at a psychiatric center. We measured heart rate variability to assess ANS regulation at night, evaluated dementia severity via the Clinical Dementia Rating scale, and obtained sleep duration data from sleep diaries maintained by psychiatric nurses. The data were analyzed using repeated-measures generalized linear models with age, sex, dementia severity, hypertension status, and medication use (antipsychotics) as covariates. A sleep duration of 6–9 h per night compared to shorter than 6 h was associated with a greater increase in parasympathetic nervous system activity (p = 0.03), and a sleep duration longer than 9 h was associated with a decrease sympathovagal balance (p = 0.02). In addition, we observed an inverted U-shaped association between sleep duration and ANS regulation. In this pilot study, we demonstrated that a sleep duration of 6–9 h per night may be beneficial for ANS regulation; however, the present study involved only a few participants and had some limitations. Additional research with a larger cohort is needed to confirm these findings.

8 March 2023 in Healthcare
Verified
Journal Article
Open access
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CLChuen-Ru Liu
Chuen-Ru Liu
TKTerry B J Kuo
Terry B J Kuo
Jwo-Huei JouJwo-Huei Jou
Jwo-Huei Jou
CLChun-Ting Lai Lai
Chun-Ting Lai Lai
YCYu-Kai Chang
Yu-Kai Chang
YLYiing Mei Liou
Yiing Mei Liou
Exposure to bright morning light (BML) entrains the master circadian clock, modulates physiological circadian rhythms, and reduces sleep–wake disturbances. However, its impact on the autonomic nervous system at night remains unclear. Here, we investigated the effects of BML exposure on parasympathetic nervous system (PSNS) and sympathetic nervous system (SNS) activity at night in elderly women. This nonrandomized controlled pilot study included female participants aged ≥ 60 years who were diagnosed with a type of dementia or cognitive disorder, excluding individuals with pacemakers. The treatment group was exposed to 2500 lx of BML, whereas the control group was exposed to 200 lx of general lighting. We measured heart rate variability to quantify ANS activity. The treatment group displayed significant increases in high-frequency (HF) power (Roy’s largest root = 1.62; p < 0.001) and nonsignificant decreases in normalized low-frequency (LF%) power. The corresponding nonsignificant decreases in the low-frequency/high-frequency (LF/HF) ratio and cognitive function were correlated with PSNS activity (Roy’s largest root = 1.41; p < 0.001), which improved severe dementia. BML exposure reduced SNS activity and enhanced PSNS activity at night in female participants, which improved cognitive function. Thus, BML therapy may be a useful clinical tool for alleviating cognitive decline.

3 January 2023 in Preprints.org
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Preprint
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CLChuen-Ru Liu
Chuen-Ru Liu
TKTerry B J Kuo
Terry B J Kuo
Jwo-Huei JouJwo-Huei Jou
Jwo-Huei Jou
CLChun-Ting Lai Lai
Chun-Ting Lai Lai
YCYu-Kai Chang
Yu-Kai Chang
YLYiing Mei Liou
Yiing Mei Liou
Bright morning light (BML) entrains the body clock, modulates circadian rhythm, and improves sleep-wake disturbances. However, its impact on the autonomic nervous system (ANS) at night remains unclear. Hence, we investigated the effects of BML exposure on activities of the parasympathetic nervous system (PSNS) and sympathetic nervous system (SNS) at night. This non-randomized controlled pilot study included participants ≥60 years, diagnosed with a type of dementia or cognitive disorder. We excluded participants with pacemakers. The treatment group received 2500 lx BML, whereas the control group received approximately 200 lx of general lighting. We measured the heart rate variability to quantify ANS activity. The treatment group displayed significantly increased high-frequency (HF) power (Roy's largest root=2.44; P<.01) and insignificantly decreased normalized low-frequency (LF%) power. The corresponding low-frequency/high-frequency ratio (LF/HF), insignificant decrease, and cognitive function were correlated with PSNS activity (Roy's largest root=3.92; P<.01), which is effective for moderate dementia. BML exposure reduced SNS activity and enhanced PSNS activity at night, which consequently affected cognitive function. Furthermore, the light washout intervention markedly increased SNS activity at night. BML therapy may be a useful clinical tool for alleviating the deterioration of cognitive function.

3 May 2026 in Quality of Life Research
Verified
Journal Article
Open access
PDF file
CLChuen-Ru Liu
Chuen-Ru Liu
MTMei-Yun Tseng
Mei-Yun Tseng
DSDipanshu Sharma
Dipanshu Sharma
WHWen-De Hsieh
Wen-De Hsieh
WLWei-Shu Liu
Wei-Shu Liu
Jwo-Huei JouJwo-Huei Jou
Jwo-Huei Jou
Purpose This study evaluated the feasibility and preliminary effects of body–mind–spirit (BMS) group therapy—integrating Eastern gratitude philosophies with Western psychotherapy—on sleep and quality of life (QoL) among adults with visual impairment (VI). Methods A quasi-experimental study recruited 30 adults with VI (mean age 61.5 ± 11.4 years, range 26–78; 53.3% female). The experimental group received 10 weekly 130-min BMS sessions; the control group received usual care. QoL was assessed using the WHOQOL-BREF, and sleep was measured through accelerometry (XA-5) and self-reports. Results Compared with the comparison group, the intervention group showed significant improvements in overall QoL (p = 0.01, d = 0.58), with the most robust effect observed in physical health (d = 0.71). While objective sleep metrics remained statistically unchanged, the experimental group reported moderate improvements in sleep latency (d = −0.32; 23% reduction) and increased satisfaction. Data stability was influenced by a perceived lack of security in wearable devices. Notably, longer sleep duration correlated with better psychological well-being (p = 0.01), while lower gains among younger participants were linked to significantly shorter baseline sleep duration associated with their occupations. Conclusion BMS therapy is feasible and may enhance QoL and subjective sleep through improved emotional regulation. Although “circadian hardwiring” may limit physiological reset, BMS offers a psychological buffer against sleep dissatisfaction. Future trials should integrate circadian-focused strategies and address cultural conservatism regarding sensitive QoL dimensions. Trial registration IRB of Taipei City Hospital (TCHIRB-11107010); ClinicalTrials.gov (NCT07105761); Registration date: 13 August 2025.

24 May 2026 in Mental Health & Prevention
Verified
Journal Article
Closed access
CLChuen-Ru Liu
Chuen-Ru Liu
MTMei-Yun Tseng
Mei-Yun Tseng
DSDipanshu Sharma
Dipanshu Sharma
WHWen-De Hsieh
Wen-De Hsieh
WLWei-Shu Liu
Wei-Shu Liu
JJJwo-Huei Jou
Jwo-Huei Jou

20 March 2024 in Preprints.org
Verified
Preprint
Open access
PDF file
CLChuen-Ru Liu
Chuen-Ru Liu
CYChih-Yuan Yang
Chih-Yuan Yang
DSDipanshu Sharma
Dipanshu Sharma
TCTun-Hao Chen
Tun-Hao Chen
XHXian-Qing Huang
Xian-Qing Huang
Jwo-Huei JouJwo-Huei Jou
Jwo-Huei Jou
This study aimed to investigate the relationship between sleep duration, dementia severity, age, and ANS regulation. This cross-sectional pilot study included 27 older patients with probable Alzheimer’s disease, hospitalized at a psychiatric center. We measured heart rate variability to assess ANS regulation at night, evaluated dementia severity using the Clinical Dementia Rating scale, and obtained sleep duration data from sleep diaries maintained by psychiatric nurses. The data were analyzed using repeated-measures generalized linear models with age, sex, dementia severity, and medication (antipsychotics) as covariates. A sleep duration of 7–8 h per night was associated with better ANS regulation than other sleep durations, as indicated by sympathovagal balance (p = 0.005). ANS dysregulation was characterized by a 20.7% increase in sympathetic nervous system activity and a 14.8% decrease in parasympathetic nervous system (PSNS) activity. We found a significant correlation between dementia severity and PSNS activity (p = 0.04) and observed an inverted U-shaped association between sleep duration and ANS regulation. This pilot study demonstrated that a sleep duration of 7–8 h per night may be critical in maintaining optimal ANS regulation. Bidirectional associations between sleep duration, inadequate sleep duration, aging, and ANS regulation warrant further investigation.