If I don't get enough sleep I feel awful. I actually wonder if you are reacting badly to the progesterone in Evorel, particularly in the conti version. Many women struggle with conti HRTs because progesterone used every day can bring low mood, anxiety and PMT - perhaps you are reacting to norethisterone more now?
Lack of sleep can play havoc with concentration and this can make us more anxious.
Maybe you need one of the kinder progesterones now?
DG x