Acetaminophen has been known to cause
liver problems
and I, for one, can only use it sparingly, due to
liver conditions. I would try to eliminate or moderate alcohol consumption and I would eliminate the Tylenol PM. Unfortunately I'm not aware of any liver friendly pain or sleep remedies. Acetaminophen, Ibuprofen, Naproxyn, etc., all tend to have negative effects on the liver. I hope this helps.