20 cm of H2O is about 0.28 PSI...pretty light. About 7.75 inches H2O, in the terms that I think in. My Respironics has a ramp feature, and I've played with the settings. Originally it was set to start at 5 in and ramp to 10 over 45 minutes. Over a few years I've gotten really used to it, and now start at 7 and do a 20 min ramp to 10.5 inches (about 26.6 cm). I know people that are a lot higher...
But yeah, a little force applied in a lot of places can move a heck of a lot. My 10.5 inches/0.36 PSI over 1 square foot (144 sq inches) is about 52 pounds of force...
RFTraveler