Akpala put Oostende 1-0 up in the 28th minute but Royal Antwerp equalised through Laurent Mendy who converted a 36th minute penalty.
Richairo Zivkovic scored in the 52nd minute to make it 2-1 to Oostende.
Royal Antwerp were back on level terms again through Joaquin Ardaiz on 55 minutes.
Five minutes after Ardaiz’s goal, William Owusu struck for Royal Antwerp to give them a 3-2 lead.
Oostende were given a lifeline as Royal Antwerp were reduced to 10 men following Nader Ghandri’s sending off on 71 minutes.
Oostende capitalised on the one-man advantage as they equalised on 88 minutes thanks to Zinho Gano.
Their next game comes up at home against Eupen on Saturday.