The last time I water fasted, I noticed I needed less and less sleep as time went on.
I believe the reason for this is that your body requires less energy it needs than it normally does with digesting food, so therefore you aren't needing the rest like you use to.
I see no reason why not take the Tylenol pm, its not like you are trying to detox right?
I personally take benedryl when I am fasting to help me sleep. I've heard of other people taking Ornithine, but I've never tried it.
I know what you are going through it can be hard because the more you think of food the more likely you will act it out and eat....., try to replace those thoughts at night with how much weight you are losing and how great you are looking and feeling every day!!!
I hope this helps.