I have read a lot of the info here, and I'm impressed by most of the theories you have a ll come up with. I have my own, which appearently differs greatly with the concensus here, but anyway, here goes...
There are 2 women in this story, Diane and Camilla. They are both real people. There are no dream sequences, per se, but there are several flashbacks and quite a bit a hallucinations (not quite 'dreams')
The story starts chronologically with young Diane winning the dance contest, and moving to L.A. to become an actress. We also begin with Adam Kesher, who is casting for his film and having marriage problems. Diane auditions for a role, but gets a small part instead in Kesher's 50's movie. The lead actress is Camilla, forced into that role by the Hollywood mafia (stranger things have NOT happened).
Diane and Camilla have an affair, but Camilla is falling in love with Kesher, and Diane is getting jelous. This culminates in a dinner party (which really happens) at which Adam brags about getting the house from his wife (who is by now long gone) and Adam and Camilla anounce thier engagement.
This sends Diane off the dep end, she may have lost her part, flopped out of any other acting jobs, and she eventually plots to have Camilla killed. This could all have happened over the course a few months or maybe a year.
So she meets the incompotent hitman (really) and pays him to do the deed, which he (indirectly) screws up. Camilla lives, crawls down the hill, and squats in a completly random apartment. To cope with the shock of what has happened, she ceates 'Betty' from the name she REALLY sees on the Winkies name tag. She really does go to Winkies, and to Diane's apartment, and to Club Silencio, but she does it with her imaginary friend, 'Betty'.
Speaking of Diane's apartment - After killing off Camilla (which for all she knew happened, because she got the blue key) Diane started loosing it. Her hatred of Camilla paired with the guilt of offing her drove her mad. The make-out scene is a simple flashback, not a dream. Just something that happened on that couch perhaps weeks or months before. Finally, she is haunted by the old folks. I think that the old couple represent a lie - a vision of innocence that is never really true, something we can never live up to. Diane's lie overcame her, and her 'innocent' past quite litterally came back to haunt her, and she shot herself.
Back to Camilla... She creates this character of Betty to satisfy several emotional needs. She is afraid because of the attempt on her life, her mind needs a 'guide' out of amneisia, and, most importantly, she creates the sweet, pure, unsullied image of Betty to make herself believe that Diane had not tried to have her killed, and that she had not had any part in driving Diane to murder or suicide. Betty was 'inocent', and would never do these horrible things.
But Camilla's hallucination begins to fall apart, and when she can no longer see Diane as 'Betty', she puts herself into that role, in the blonde wig. She goes to Silencio (maybe she had gone there with Diane) and the show triggers her memory, which is symbolized by the blue box.
The Cowboy is Diane's hatred for Adam personified.
The dwarf (lil' Mike RULES) is not just the evil of Hollywood, but just the evil of life in general. The forces that act against us. He is, well... the arm
I is the general idea. I don't pretend to have all the details worked out, but you get the idea. Have fun!