It doesnt build up like what one would if left for months. Its very minimal in my system because i do it frequently. If you have not touched it for a while, only do it in sections at a time.
I have never used a vaccuum on the sand, that is what my sump is for after cleaning.
Keep in mind, if you use a sand substrate, it will make a mess on the lr which then would include turkey bastering it off.
Ive seen alot of people leave their sand beds alone, but i just personally like the look of muck build up in the substrate. This is my preferance by far and may not be the only option out there. Good luck