I have never used just play sand alone, but I have read about several people that have and it seem to be about the same.
One problem a lot of people seem to have with sand is the cleaning, it can be tricky to clean, but not impossible, and the look, it will be bright and soon it will not, I like the change personally, but many do not.
Sand can cause some problems if it get in the impeller of the filter, ans turning off the filter when cleaning or stirring up the sand is all you need to do.
You can get anaerobic spot (rotten egg smell) if the sand bed is too deep or if it is smothered by too large of decoration, poor aeration in general, you can either use a stick and poke the sand bed weekly or trumpet snails and stem plants will help keep that problem in check by pulling oxygenated water into the sand bed.
Large decoration should be put in first and then the sand to help avoid dead spot under them.