Atomic force microscopy (AFM) plays an essential role in nanotechnology and nanoscience. The recent advances of AFM in bionanotechnology include phase imaging of living cells and detection of biomolecular interactions in liquid biological environments. Deflection sensitivity is a key factor in both imaging and force measurement, which is significantly affected by the coupling effects of the refractive index discontinuity between air, the glass window and the liquid medium, and the laser spot size and spot location. The effects of both the spot size and the spot location on the sensitivity are amplified by the refractive index discontinuity. The coupling effects may govern a transition of the deflection sensitivity from enhancement to degradation. It is also found that there is a critical value for the laser spot size, above which the deflection sensitivity is mainly determined by the refractive index of the liquid. Experimental results, in agreement with theoretical predication, elucidate the coupling effects.