I will often take Sudafed, particularly while using full face masks, since continuous equalization with them -- even if one is only slightly congested -- can pose a bit of a challenge. A "valsava nose block," as musical and appealing as that may sound, is no substitute for open access to one's nose.
I haven't experienced any CNS related issues with the medication of which I am aware, regardless of the studies and claims that I have read, over the years; nor experienced anything at any given depth or air mixture, for that matter; but I do sorely miss those bygone days, when one could buy bottles of five-hundred capsules of pseudoephedrine at Sam's Club or Costco, before the ascendency of crack.
Timing dosages of Sudafed, though, like most things in life, is everything. I once experienced a terrible reverse block, when I delayed getting into the water; and that produced the most excruciating pain and the most impressive "Hollywood" bloody nose that I have ever experienced, one that I could "taste / smell" for two days.
Now I regularly receive the stink eye from the pharmacist at Walgreen's when I buy two packages of eighteen -- and have to dig through the wallet for my license, and assure them that my teeth aren't the color and texture of candy corn . . .