RichardKennaway comments on False vacuum: the universe playing quantum suicide - Less Wrong
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Ignore them?
Why do you need answers to these questions, so intensely that being unsure is "making [you] a little sick"? There is no Omega, and he/she/it is not going to show up to create these scenarios. What difference will an answer make to any practical decision in front of you, here and now?
While Omega is not real, it seems possible that naturally occurring things like false vacuum states and Boltzmann brains might be. I think that the possibility those things exist might create similar dilemmas, am disturbed by this fact, and wish to know how to resolve them. I'm pretty much certain there's no Omega, but I'm not nearly as sure about false vacuums.
I'm reminded of this part of The Moral Void.