I'm using special reef grade sand, about 1" deep, over a 60" x 30" footprint tank, with fairly minimal rockwork. Lots of open sand.
Prior to last November, I did a 20% water change, using a gravel vac, every other week. Tried to get as much gunk out of the substrate as I could.
Last November, I implemented an Auto Water Change system (AWC). Haven't touched a gravel vac, or carried a bucket of water, since then. Tank is happier than ever.
I currently have 2x Sand conchs and a Goatfish, maybe half a dozen Nassarius snails. Thinking seriously about adding another handful of Nassarius snails, and maybe even a sand sifting starfish. Might even do a more agressive sand sifting fish... diamond goby or some such, just to make up for me not moving the sand around manually.