Myotonic dystrophy type 1 (M. Steinert) is a complex genetic disorder marked by progressive muscle weakness, myotonia, and respiratory insufficiency. Effective respiratory management is crucial, particularly as hypoventilation and inadequate ventilation effort often complicate the disease progression. This clinical case demonstrates how the Vivo 45 ventilator, equipped with advanced monitoring tools like transcutaneous CO₂ measurement and effort belts, provides detailed insights into respiratory function. These technologies enable precise assessment and optimisation of ventilatory support, ensuring tailored care for the patient. This approach highlights the transformative role of advanced monitoring in managing the respiratory challenges of M. Steinert patients.