Sand takes a little work. You have to clean it, or either let it settle in the tank, which can take a couple of days. Other than that, there's really not much difference. Instead of just gravel vac'ing, you stir up the sand and suck up what comes up -- the poo and fine sediment. After time, there should be less fine sediment. I use play sand in my 125, and though it was very dirty, and took time to settle, now, it's just fine, and there's no sediment at all (it's been about a year, though). Overall, it is a more natural bottom. Different members have different opinions on using sand from an actual lake... you can probably search and find these threads. Some feel you should boil it, some say bake it.... the idea is that there are yuckies in this sand you don't want in your tank (insect eggs, larvae, parasites, etc.). So, you might want to research that, and I've never done it, so I have no experience there. However, you can buy play sand for 5 dollars for 50 pounds at your local home improvement store, so it's cheap, and you don't have to really clean it if you have a place to move your fish while it settles. You can clean it in a bucket, just washing it and letting the water and sediment come over the top, but I think either way, you're going to have some cloudiness. There's also pool filter sand, which some people use, but I have no experience with, so you'd need to search out threads on that. Hope this helps.