I was reading Paul's 47yo reef thread and he made a mention about DSBs having a limited life span (up to a decade). This really hit home for me and made immediate sense - but I just like the look of sand!
For me the biggest pain has been maturing. I started with dry sand and live rock.
As much as a sympathize with with the idea of never disturbing a DSB, the dead spots are essentially wasted area in your bio filter. I had to stir up chunks quite regularly to dissipate the dead spots, I now have some extra cuc taking care of that. Ive always had a low nutrient tank so I think the balance needs to be found to provide the dsb with "food" to let it actually grow these anoxic bacteria's and all the other micro crustaceans.
6Mths in I almost have a mature sand bed. I still dose bacterias from various brands.
As I said before I did it purely for the look, I don't run a fuge or a scrubber and I've never had a nitrate problem, making up for the relatively non porous LR. I did use a homemade scrubber for a few weeks though and it worked on overtime, suggesting macros might be a more efficient nitrate sink.
Moving/removing a DSB I'd put animals in quarantine as the gradual buildup of hydro sulfide will have to have an effect. I don't have the numbers to back it up but I've had the black spots.