Hi DLC,
I wonder if your reaction to the patch could be due to the sudden introduction of hormones, especially if you have been post menopausal for a few years. Perhaps you could start with just half a patch, or even a quarter and build up slowly over a few weeks. If you do react badly to the progesterone element then obviously find out about changing to a different HRT. The jittery feeling and lack of sleep sounds like a surge in estrogen, if you add a little at a time it may give your body a chance to get used to it. I found that Evorel Conti helped with sleep, aches and pains and flushes quite quickly. I was 54 when I started using it and still in peri menopause, so my own hormones were still very active and it wasn't such a shock to the system when adding some more.
Anyhow if you try a smaller dose and still get those jittery feelings straight away then just remove the patch and have another word with your doctor.
Hope you find something that helps,
Fionalowri